THE GENTLEMAN'S
MEDICAL
w
TRAVELLING COMPANION.
CONTAINING A CONCISE STATEMENT
OF THE MOST KNOWN AND CERTAIN CAUSES, SYMPTOMS
AND MODES OF CURING EVERT DISORDER TO WHICH
HE IS LIABLE, WITH DIRECTIONS FOR HIS COS-
DUCT IN CASE OF ACCIDENTS ON THE
ROAD OR AT SEA.
IN PLAIN ENGLISH.
&£7/?/
BY H. JWMURTRIE, M. D. fa.
PHILADELPHIA :
PUBLISHED BY A. R. FOOLI,
60 Chetnut Street.
1824
23Ltm*vU*.
Professional pride, in all ages, has delight-
ed in shrouding the divine art of healing dis-
eases, under a complicated and barbarous jar-
gon of words, which, from being always un-
intelligible to the community at large, (and
sometimes so to itself,) serves the double
purpose of preventing all but the initiated
from endeavouring to penetrate its mysteries,
and of exciting that respect it delights in ex-
acting. Common sense has long since stripped
the physician of his wig, black suit, gold-
headed cane, and that still more ridiculous ap-
pendage, the sword, while it has permitted
the art he professes, to remain encumbered
with trappings equally as useless.
It is a matter of surprise that some one
of abilities and courage equal to the task, has
not undertaken to clear away the rubbish
which at present disfigures and hides the fair
proportions of the beautiful Temple of Medi-
cal Science ; for then, and not till then, will its
excellence be apparent to all, and its builders
receive the full reward of their labours, which
is only to be found in universal utility. Why
should any discovery that tends to relieve
pain, preserve health, or prolong life, be
locked up from that world whom it so vitally
concerns, in the mysterious jargon of techni-
a2
VI REMARKS.
cal terms, delivered in a language which not
one in a thousand even pretends to understand ?
ilt is neither an ingenious argument nor a fine
Greek word that can restore the sick man to
health.
The practice of medicine should be con-
ducted on those general principles, which are
drawn by sober experience, from a careful
observation of the effects of remedies upon
the human body, in its different stages of dis-
ease. The surgeon has " day light and fair
play ;" not so the physician. He is often com-
pelled to work in the dark, and then it is that
these principles, like skilful pilots, guide him
safely through surrounding dangers. Simpli-
city is beauty, and one of the most striking
characteristics of the practice of physic, is its
simplicity. The great leading principles which
guide us by the bed sides of our patients, are
few, short, and easily understood ; they are
applicable in every disease to which the hu-
man body is subject, although they may not
always prove equally successful. It is the ju-
dicious use of them which constitutes the great
merit of the enlightened physician.
In a matter of such immense importance to
every individual, it would seem necessary
then, that these principles be as widely dis-
seminated, and in as plain words as possible,
in order that every one may know and under-
stand them. To do this, is every man's duty,
as well as interest, for, independently of his
own life, which is frequently jeoparded by
REMARKS. Vli
the want of such knowledge, that of his neigh-
bour is often by accident placed in his hands.
To some particular sections of our exten-
sive country, and to travellers especially, this
consideration is of the utmost importance. I
have known a considerable district in one of
our western states, which contained but one
doctor, and him I have met on his way to his
patients by eight o'clock in the morning so
drunk, as rendered it necessary to lift him
into his gig! Sometimes there is no physician
of any kind to be obtained, or if there be, af-
ter waiting until the complaint has got to a
height that baffles all remedies, he arrives in
a state similar to that described ! What be-
comes of the sick, under such circumstances?
to follow the directions, or swallow the medi-
cines of a man in this condition, would be per-
fect madness ! — they must depend upon them-
selves or their friends. With that knowledge,
which I feel sure the plainest capacity can
readily obtain from this book, they will be en-
abled to take such steps, as at any rate will
not increase their complaints, but on the con-
trary, by proceeding on the general principles
laid down in it, bring them to as happy an is-
sue as the nature of the case may admit.
It was on an occasion* somewhat similar to
that just mentioned, that the necessity of some
* This was during the late war, and in the interior
of Pennsylvania, where I was forced to witness the
death of an unfortunate man, who fell a victim to
the culpable ignorance of his medical attendant.
In consequence of a severe fall, a total buppressicm
V1U REMARKS.
cheap, plain work, like the present, first sug-
gested itself to my mind. Those books that
have been intended for like purposes, seem to
me, too bulky, too learned, or too expensive.
A few short and intelligible directions are soon
read, easily retained in the mind, and are al-
ways ready for application on the " spur of the
occasion," while those of a different character
only serve to bewilder and lead astray.
As these pages are intended exclusively for
the use of men, no diseases peculiar to women
or children will be treated of in it. My aim
is to be useful. I have endeavoured within a
small compass, and in as plain a manner as
possible, to lay down such rules and give such
directions, as will enable every one who reads
them to adapt to his (or his friend's) case, the
plan of treatment most proper for it.
To the various writers to whose works I
am indebted for much valuable matter, I have
made no reference, as it would have occupied
too much space. I have, however, made free
use of the most valuable of such as are con-
sidered authorities, and in some instances will
be found to have adopted their very words.
of urine came on ; notwithstanding it lasted several
days, no attempt was made to empty the bladder,
which from excessive distention, ulcerated, poured
out its contents into the belly, producing inevitable
death, from inflammation, &c. I afterwards ascer-
tained that his doctor, not only did not dream that a
catheter* was necessary, but that he actually had no
such instrument in his possession !
* A hollow tube to be passed through the urinary passage into
the bladder ; they are made of silver and of an clastic gum.
HINTS TO TRAVELLERS,
The sudden changes of weather, which so
particularly characterize the climate of the
United States, render a supply of flannel to be
worn next the skin a matter of much conse-
quence to the health and comfort of the tra-
veller, who is more exposed than others to
the morning and evening damps, as well as
the meridian heat.
As a general preservative of health, I know
of no habit more valuable than this ; the dis-
agreeable irritation of the skin it occasions at
first, soon wears off, and it then becomes plea-
sant. The objection to it during the summer
months, are more specious than solid. Accus-
tomed to be cased in it from head to foot, in
the East and West Indies, as well as in the
southern parts of America, I have uniformly
had occasion to remark that I suffered less
from the heat than such of my friends as wore
none. This is now generally admitted to be
the consequence by scientific men, and is easi-
ly accounted for on principles, with which my
limits do not permit me to meddle. I merely
mention the fact, and again seriously recom-
mend every one who wishes to preserve his
health in this climate, to have immediate re-
course to flannel, and never to leave it off.
A phial of laudanum, one of strong essence
of peppermint, with a few doses of calomel or
It) HINTS TO TRAVELLERS.
a box of the Wyndham (Lee's) pills, should al-
ways have a corner in every traveller's trunk
they take up but little room, and should he
proceed without them, a few days, perhaps
hour^, may give him serious cause to regret
it. The writer was once passenger in a public
stage when one of the company was taken
with a violent colic; so severe and agonizing
was the pain, that we were compelled to stop
with him at a miserable log house, by the road
side, where no medical aid could be obtained,
and when he probably would have died, but
for the little articles above mentioned, which,
with a lancet he knew well how to use, an
old traveller drew from his saddle bags.
While in a high healthy country, there is no
absolute necessity for observing the following
rules, which become indispensable while in
a low, marshy, and consequently a sickly one.
JVeow leave your sleeping place in the morning,
until the fog and damp have been dispersed by
the sun ; if, however, you are not master of
your own movements, and cannot avoid it, al-
ways endeavour to have a cup of coffee and a
crust of bread before you set out ; this can
generally be had, by speaking to the landlord
the preceding evening. If you are disappoint-
ed, a glass of wine with a few drops of pep-
permint and a little sugar in it, will answer;
and in default of the wine, spirits of any kind
prepared in the same way, with or without
bitters. By these means your stomach will be
fortified, and one great avenue to disease be
HINTS TO TRAVELLERS. I I
blocked up, always recollecting that it is as a
medicine you are to take it, not to gratify
your palate. The practice is unfortunately
too apt to be continued, when all necessity for
it has ceased, and mint julaps, like some other
good things that are abused, have wrecked
many an honest and good man : coffee should
always be preferred if it can be obtained.
To mention the propriety of examining
closely, the beds you are to sleep in, may at
first sight seem superfluous, to say nothing
more of it. It is not, however, the refreshing
luxury of clean sheets, that is the principal
inducement to caution, but the great risk you
run of contracting disorders by sleeping in dir-
ty ones. I have known a want of care in this
point, punished by a severe clap. Many trou-
blesome and disgusting diseases of the skin,
are communicated in this way, without any
idea being entertained of their origin. For my
part, a great coat and a clean plank, a sofa or
three chairs, would be preferred to running
any risk whatever.
Every man should know how to bleed. It
is an operation so extremely easy in itself, and
so important in its effects, that it ought to be
universally understood. There is no difficulty
or mystery in the matter, and any one who has
the command of his fingers and eyes, can ac-
quire in five minutes that skill, which may en-
able him to save many a life.*
Change of water is very apt to produce
j jome little disturbance in the bowels, and this
* See directions for bleeding-.
12 HINTS TO TRAVELLERS.
to a stranger, is one of the sure marks of being
in a lime-stone country. If it act gently, it need
not be minded, if otherwise, mix wine, porter,
or brandy with it, or omit the use of it altogeth-
er, for a few days, when it may be gradually re-
sumed ; in this way its eifects are diminished.
To prevent as much as possible any danger
from frost, while travelling in excessively cold
weather, having well cased your whole body
(and feet in particular) in warm clothing,
avoid approaching the fire, and the use of spi-
rits, or hot drinks of every description. When
i you stop on the road, instead of seating your-
I self by the chimney and calling for liquor,
walk about in the open air as rapidly as pos-
sible, and if you are thirsty, take a glass of ci-
der or cold water. Three men (with one of
whom I am personally acquainted) set out from
Boston for Upper Canada, during the middle
of a very severe winter, each one driving
his own sleigh ; two of them were in the
habit of stopping at every tavern they came
to, warming their feet and drinking freely
of hot toddy. The other never entered a
house, except for his meals or to sleep ; while
his horse rested, he stretched his legs, and
when he was dry he partook of the same ele-
; ment with his beast. The consequence of this
i was, that out of the three, he was the only one
i who arrived at his journey's end uninjured.
One of his companions had his feet so badly
frost-bitten, that he lost them both, and the
other was taken out of his sleigh, at the door
HINTS TO TRAVELLERS. 13
of a tavern, where his horse naturally stopped,
frozen to death ! If, notwithstanding all jour
care, you become much affected by the cold,
remember never to go to sleep — no matter
how strong the inclination may be, resist it for
vour life — it is the sleep of death !
Never let false delicacy, or any other cause,
prevent you from emptying the bladder as
often as you feel the inclination : a painful and
lingering, sometimes an incurable disease arises
from neglecting this call of nature.
Before retiring to rest, be careful to close .
your windows. One of the most fruitful sour-
ces of sickness, is found in the night air, that
is generally damp, and loaded with poisonous
vapours, and which, from the relaxed state of
the body during sleep, is more apt than at any
other time to produce the most mischievous
effects.
GENERAL RULES.
All diseases might, with great propriety,
be arranged under three heads, viz : Inflam-
matory diseases, or those attended by increased
action, as shown by a quick, full, hard or
strong pulse, — great thirst and heat, — white,
or red tongue, — flushed face, — blood-shot eye,
&c. &c.
Diseases of debility, accompanied and mark-
ed by a small, soft, feeble, slow, or intermit-
ting pulse, — a shining white or dark tongue, —
languor and weakness, — cold clammy or burn-
ing skin, and an internal sense of sinking.
Diseases either of increased or diminished ac-
tion, producing particular effects, and requir-
ing specific remedies.
Although I have not thought proper, (for
reasons presently to be mentioned) to adopt
this arrangement, 1 have been induced to
glance at it, as giving rise to those great lead-
ing principles or rules, which should govern
us in the management of all diseases, and
which, if attended to, will be followed by con-
sequences as beneficial as the nature of the
circumstances will admit.
Rule I.
In every complaint, whatever it may be
called, if you find the pulse quick, hard, full,
and strong,— the head ach, — tongue foul,—
GENERAL RULES. 1 5
skin hot, or those marks which denote it of
an inflammatory nature, remember the plan is
to reduce it by bleeding, — purging, — low diet,
— drinking plentifully of cold water and le-
monade, — rest, &c.
Rule II.
If on the contrary, the pulse be small, soft,
feeble and intermitting, — the tongue dark, and
great debility or weakness is evident, reverse
the whole plan ; the diet must be generous
and nourishing, — the bowels opened with gen-
tle laxatives, — and the strength supported by
bark, sulphate of quinine, wine and tonics of
various kinds.*
Rule III.
If in addition to those symptoms mentioned
in the second rule, the tongue be covered
with a black coat, — foul dark looking sores
form about the gums and insides of the cheeks,
—the breath be offensive, &c. the same class of
remedies is to be vigorously employed, with a
free use of acids and other antiseptict articles.
• It is necessary however, to be careful in dis-
tinguishing the weakness which is here meant,
from that state of debility which arises from exces-
sive action, from the stuffing- up of the vessels, and
which requires the lancet. As a mistake might prove
fatal, attention should be paid to the pulse, by which
they can be easily known. In that state which re-
quires tonics, the pulse is small, soft,— -sometimes
like a thread and quick. In the other, it is slower
and full, giving considerable resistance to the pres-
sure of the finger.
t Medicines which prevent or correct putrefac
tion. See Putrid Fever.
1G GENERAL RULES.
Rule IV.
Severe local pains, as in the head, side, &c.
require the use of* the lancet, purging and
hlisters to the part.
Rule V.
Incessant and earnest entreaties on the
part of the sick, for any particular article of
diet, if steadily persevered in, may he safely
indulged, whether the use of it agrees or not
with our preconceived ideas on the subject.*
Rule VI.
In all fevers, where the pulse is quick,
fill] and strong, — the skin burning to the
touch, and there is no perspiration, dash cold
water over the head and shoulders of the pa-
tient, wipe him dry and put him to bed. If
in consequence of this, a chill be experienced,
and the puise sink, give warm wine, &c. and
* These longings after certain articles, are nothing
else than the instinctive efforts of nature to rid her-
self of the disease, by such means as are best adapt-
ed to that end. I have had ample experience of the
truth, safety and importance of this principle, both in
my own person and those of my patients. 1 have
known physicians refuse a man who was labouring
under an obstruction of the bowels, raw onions,
which he insisted upon having, and which he at last
procured by stealth ; to the astonishment of his at-
tendants, a copious evacuation succeeded this deli-
cate cheer in the course of a short time, and what
art had in vain attempted for his relief, during many
days, was accomplished by nature in a few hours.
Thousands of such instances could be brought for-
ward if necessary.
GENERAL RULES. \~i
omit the water for the future. Should a plea-
sant glow, over the whole frame, follow the
affusion, and the patient feel relieved by it, re-
peat it as often as may be necessary.
Rule VIIL
Observe carefully, the effects of various ar-
ticles of food, as well as physic, upon your
own body, and choose those which experience
proves to agree best with you. It is a vulgar
but true saying, that " What is one man's meat,
i* another's poison."
Rule IX.
Keep a sick room always well ventilated-
Plenty of fresh air is an important remedial
sgent in all diseases.
k2
DIVISION OF DISEASES.
It is a matter of no consequence with what
particular complaint we begin, since each one
is to be described. All systems are artificial
and liable to objections, but for the purpose
of enabling every one to find out his ailment,
and to refer at once to its mode of treatment, I
have adopted the following plan. In some
points of view it may be exceptionable, but it
suits the purpose I intend it for, — the conve-
nience of my reader, who may possibly care
as little as I do, whether the arrangement be
scientific or not. In the first place, there are
such diseases as produce a general disturb-
ance, that is visible throughout the whole
body. These are found in fevers.
Simple Inflammatory Fever.
Intermittent, or Fever and Ague.
Bilious Remittent Fever.
Typhus or Low Nervous Fever.
Putrid Fever.
Hectic Fever.
Next we have those whose effects, though
extended to the whole body, commence in
and are chiefly confined to, particular parts
such as diseases incident to
1.
The Head,
2.
Throat,
3.
Chest,
4.
Stomach,
5.
Liver,
6.
Intestines
7.
Kidneys,
8.
Bladder,
DIVISION OF DISEASES. 19
9. Genital Organs, 10. Joints,
11. Nerves, 12. Glands,
13. Cellular Mem- 14. Skin, including Tu-
brane,* mours, Ulcers, &.C
Lastly, under the " Chapter of Accidents,"
will be considered all those unfortunate occur-
rences, which are daily thinning the ranks of
society, which human prudence cannot always
prevent, and to which, all who travel by land
or water are more particularly exposed.
* This is a kind of fatty net-work, lying immedi-
ately under the skin, and covering the whole body.
THE GENTLEMAN'S
MEDICAL VADE-MECUM.
OF THE PULSE.
The pulse is nothing more than the beating
of an artery.* Every time the heart contracts,
a portion of blood is forced into the arteries,
which dilate or swell to let it pass, and then
immediately regain their former size, until by
a second stroke of the same organ, a fresh
column of blood is pushed through them, when
a similar action is repeated. This swelling
and contracting of the arteries then constitute
the pulse, and consequently it may be found in
every part of the body where those vessels
run near enough to the surface to be felt.
Physicians look for it at the wrist, from motives
of convenience.
The strength and velocity of the pulse va-
ry much in different persons, even in a state of
perfect health. It is much quicker in children
than in adults, and in old men, it grows more
slow and feeble, owing to the decreased ener-
* There are two kinds of blood-vessels in the hu-
man body: arteries and veins. The arteries carry
the blood from the heart to the extremities of the
body, where they are connected with the veins
which bring it back again. An artery pulsate* or
beats ; a vein does not.
<<■& THE GENTLEMAN'S
gy of the heart. The pulse is increased both in
strength and velocity by running, walking, ri-
ding, and jumping; by eating, drinking, singing,
speaking, and by joy, anger, &c. It is diminish-
ed in like manner, by fear, want of nourish-
ment, melancholy, excessive evacuations, or
by whatever tends to debilitate the system.
In feeling the pulse then in sick persons, al-
lowance should be made for these causes, or
what is better, we should wait until their tem-
porary effects have ceased.
A fall., tense and strong pulse, is when the
artery swells boldly under the finger, and re-
sists its pressure more or less ; if, in addition
to this, the pulsation be very rapid, it is called
quick, full, and strong; if slow, the contrary.
A hard, corded pulse, is that in which the
artery feels like the string of a violin, or a
piece of tightened cat-gut, giving considerable
resistance to the pressure of the finger.
The soft, and intermitting pulses, are easily
known by their names. In cases of extreme
debility, on the approach of death, and in some
particular diseases, the artery vibrates under
the finger like a thread.
In feeling the pulse, three or four fingers
should be laid on it at once. The most con-
venient spot to do this, as already mentioned,
is the wrist, but it can be readily done in the
temple, — just before, and close to the ear
in the bend of the arm, — at the under part of
the lower end of the thigh, among the ham-
strings, — and on the top of the foot.
MEDICAL VADE-MECUM. £3
OF FEVER.
Fever is, by far, the most common complaint
to which the human body is subject. It may
be briefly described as a combination of heat,
— thirst, — loss of appetite, — weakness, and in-
ability to sleep. It makes its appearance in
two ways: either suddenly and violently, or
gradually and gently. When it comes on in
the first manner, a cold shaking, attended with
sickness at the stomach, or vomiting, marks its
access ; the cold is more severe than in the
latter, as is also the pain in the head, and other
symptoms. When its attack is gradual, a feel-
ing of soreness over the whole body, such as
is experienced after a hard day's work by
«ne not accustomed to it, shows its approach.
Nausea, pains in the head, chills, and more or
less heat and thirst soon follow.
As these symptoms vary infinitely in their
degrees of violence, the vigour of the treat-
ment to be pursued, must differ accordingly.
Thus the same directions that are given for
simple inflammatory fever, must be adhered
to. in one whose symptoms are lighter, though
similar, only there is no necessity for pushing
them to so great an extent.
SIMPLE INFLAMMATORY FEVER.
SYMPTOMS.
Chills, — flushed face, — skin hot, — eyes red.
—liaise quick, full, strong, and regular, —
jjieat thirst, — tongue white, — urine high-cu-
24 the gentleman's
loured and small in quantity,— bowels costive,
— breathing quick, lie.
CAUSES.
Cold, — violent exercise, while exposed to
the heat of the sun, — intemperance, — the in-
dulgence of unruly passions.
DISTINGUISH IT
From Typhus, by the strength and hardness
of the pulse, — white tongue and high colour-
ed urine.
TREATMENT.
Bleed the patient at the very beginning of
the attack. The quantity of blood to be taken,
should be regulated by the strength and age
of the person, and the violence of the symp-
toms. In this country, where diseases are very
acute, from 12 to 15 ounces is an average
quantity, for a robust man. If there be great
pain in the head, shave it and apply a blister,
or cloths wrung out of iced vinegar and water,
frequently renewed. The bowels are to be
freely opened, with Epsom or Glauber salts,
and the diet should consist of plenty of cold
water, rice water, or lemonade. If the heat
of the body be excessive and burning to the
touch, and there is no perspiration, take the
putient out of his bed, support him on his
feet, and let several buckets of cold water be
poured over his head and shoulders, in rapid
succession, then wipe him dry and replace
him in bed ; should he not be able to stand
lay bim on the floor, and dash the water over
MEDICAL VADE-MECUM. 25
him in that position. If from excessive weak-
ness, or a groundless tear of the consequences,
this is objected to, sponge the whole body
with cold vinegar and water. All these reme-
dies are to be repeated, until the disease is
overcome. If there be intense pain in the
head or side, apply a blister. The saline* mix-
ture No. 1, will be found useful throughout ;
and to promote perspiration, five or six grains
of Dover's powder, taking care not to drink
any thing for some time after it. An emetic
at the very onset, sometimes cuts short the
disease. The room should be kept quiet, cool
and dark, every source of excitement being
removed.
INTERMITTENT, OR FEVER AND
AGUE.
Of this fever, there are several varieties,
which differ from each other only in the length
of time that elapses between their attacks.
There is one called quotidian, in which it
comes on every twenty-four hours ; another
named tertian, in which it arrives every forty-
eight hours, and the third quartan, because
the interval lasts seventy-two hours.
SYMPTOMS.
The symptoms of fever and ague, are, un-
fortunately, too well known among us, com-
mencing with yawning, — stretching and un-
* See prescriptions, at the end of the book.
c
26 THE GOTTI KMAN's
easiness; this is succeeded by slight chills or
shivenngs, that end in a violent or convulsive
shaking of the whole body. This is the cold
tit, and is immediately followed by the fever
or hot fit. The pulse rises, — the skin becomes
hot, — pain in the head, — tongue white, and
all the marks of fever, terminating in a pro-
fuse sweat, which gradually subsiding, leaves
the patient in his natural state, though some-
what weakened.
CAUSES.
Impure air from ponds, marshes and decay-
ing vegetable matter.
TREATMENT.
As it is not possible to confound this with
any other disease, I pass at once to the treat-
ment. On the first alarm that is given by a
chill, or any of those feelings indicative of its
approach, take 50 or 60 drops of laudanum, in
a glass of warm wine, with a little sugar and a
few drops of the essence of peppermint, get
into bed, and cover yourself with several
blankets; this has seldom failed, in my own
practice, to cut short the disease. If the cold
fit, however, has passed by, the laudanum
alone may be taken during the hot one, — the
next accession should be carefully watched,
and the same remedy resorted to. If the in-
flammatory symptoms seem to require it, bleed
and open the bowels with senna and salts;
when this is done, in the intervals, use a ta-
MEDICAL VADE-MECUM. 27
ble spoonful of the quinine mixture,* three
or four times a day ; if it cannot be procured,
take as large doses of Peruvian bark as the
stomach will bear; in addition to this, en-
deavour during the cold fit to bring on the
hot one, as speedily as possible, by warm
drinks, bladders or bottles filled with warm
water applied to the soles of the feet and the
stomach. Weak whiskey punch answers this
purpose very well, it also is of use by inducing
sweat, when the hot stage is formed. If the
disease resist this treatment, try 6 drops of
Fowler's solution of arsenic three times a-day,
with the bark, gradually increasing it to 9 or 10
drops at each dose. As this is a powerful reme-
dy, care must be taken to watch its effects ;
if it produce sickness at the stomach, it must
be laid aside. To restore the tone of the sys-
tem when getting better, remove to a healthy
pure air, use gentle and daily exercise, with
a generous diet, wine and bitters. If the liver
or spleen become affected, recourse must be
had to mercury.
■♦»
REMITTENT FEVER.
This is a kind of fever which occasionally
abates, but does not entirely cease, before a
fresh attack comes on, so that the patient is
* Much mischief is done by giving either this pow-
erful medicine or the hark too early, in the disease
and before its inflammatory stage is passed. It should
never be employed until the bowels have been well
opened and the inflammation reduced.
£3 THE GENTLEMAN'S
never completely free from it. The symp-
toms are of three kinds. When bile predomi-
nates, it is called Bilious Remittent or Bilious
Fever, which in a highly aggravated state is
the true Yellow Fever of the United States
and West Indies. — This constitutes the first
kind of remittent.
The second is marked hy debility, when it
is called typhus or low nervous fever.
The third exhibits all those marks of debili-
ty and putrescency, which constitute putrid
fever.
BILIOUS FEVER.
SYMPTOMS.
In this disease, all the marks of great excite-
ment and a superfluity of bile are visible ; the
skin is hot, — the poise tense and full, — tongue
white in the commencement, changing to
brown, as the fever increases, — breathing
hurried and anxious, — bowels very costive,
and skin of a yellowish hue. In bad cases,
there is pain in the head, — delirium, — the pa-
tient picks at the bed clothes, — a convulsive
jerking of the tendons at the wrist, — tongue
black and furred, — a deep yellow skin, — vo-
miting of a dark matter, that looks like collee
grounds, — hiccup and death. When the lat-
ter symptoms prevail, it is called yellow fe-
ver.*
* Much discussion still exists among' medical men
on tliis subject, some of whom assert yellow fever to'
be a distinct disease. To enter on the dispute would
be a mere waste of paper. 1 would only observe that
MEDICAL VADE-MECUM. 29
CAUSES.
A peculiar poisonous vapour from ponds,
marshes, and decaying vegetable matter.
TREATMENT.
This must be conducted on our general prin-
ciples. As the inflammatory and bilious symp-
toms are the most prevalent at the commence-
ment, bleed the patient freely, and repeat the
operation if the pulse seems to require it.
The next step is to cleanse the stomach with
an emetic, which having operated, open his
bowels with calomel.* The lancet and calomel
are the two sheet-anchors in this disease, and ir-
resolution or timidity in the employment of them
at the beginning of it, may cost the sufferer his
life. From ten to twenty or thirty grains of
calomel, combined with a portion of jalap,
may be given in molasses, and repeated until
this " splitting of hairs," this nice and critical dis-
tinction between the varieties and stages of the same
complaint, can lead to no good practical end. So
various and changeable are the forms which the same
disease assumes, that if each one is to be considered
distinct, and dignified with a new name, physicians
will find their whole lives inadequate to acquire the
mere nomenclature of the science, and their books,
already sufficiently bulky, be swelled to a size that
would rival the legends of the Monks. If mystifica-
tion be the object, this is a sure way to obtain it.
* I here allude to those high grades of bilious
fever incident to the southern and western states.
In the common fall fever of Pennsylvania, copious
purging with senna and salts answers the purpose
c 2
yO the gentleman's
copious evacuations are produced. The quan-
tity of this medicine (calomel) that is required
to dislodge the accumulation in the bowels, in
some cases of this complaint, is almost incredi-
ble to those who have had no experience of
it. If the pain in the head be very great,
shave it and apply a blister. Should the skin
be very hot, and great thirst and restlessness
prevail, dash cold water over the bod}', as di-
rected in simple inflammatory fever. The
diet should consist of rice-water, lemonade,
&c. taking care to keep up a discharge from
the bowels by purgatives, during the whole of
the disease.
If, however, in spite of all endeavours to the
contrary, the complaint seems advancing, en-
deavour to bring on a salivation, as quickly as
possible. To eifect this, one of the powders
No. 3, may be taken every three hours. In
cases which bear a threatening aspect from
the beginning, it is perhaps the safest plan,
having previously bled and purged, to salivate
at once and without waiting till the secondary
and more dangerous symptoms show them-
selves. The moment the mouth is affected,
and the patient begins to spit, omit the medi-
cine. As soon as symptoms of putrescency
make their appearance, no mercury should be
given internally ; on the contrary, bark, wine,
acids, &c. are necessary to support the patient,
who should be kept clean, cool and comfort-
able, excluding all noise. The extreme ir-
ritability of the stomach, which is frequently
MEDICAL VADE-MECUM. 31
found in bilious fever, may be overcome by
the effervescing draught No. 9, and in the lat-
ter stage of it; when the pulse flags, and the
system appears sinking,* the quinine mixture
has been found extremely useful. Blisters and
mustard poultices, may also be applied in this
case, to the ankles, thighs and wrists.
There are in fact two distinct stages in this
disease that require two different plans of
treatment. The first is bilious and inflamma-
tory, and should be met by bleeding, vomit-
ing, purging with calomel, or a salivation,
blisters to the head and the affusion of cold
water.
The second is putrid and bilious, and must
be treated by wine, brandy, the quinine mix-
ture, sound porter, and the peculiar plan re-
commended in putrid fever; always recol-
lecting that if we can bring on a salivation
early in the disease we have a fair chance of
saving our patient.
TYPHUS, OR LOW NERVOUS FEVER.
SYMPTOMS.
Languor, — debility, — dejection of mind, —
alternate flushes of heat and chills, — loathing
of food, — confusion of ideas. These are suc-
ceeded by vertigo, — pain in the head, — diffi-
* Rubbing the body freely with the decoction of
Spanish flies in turpentine, and the internal use of the
quinine, are invaluable remedies in all such cases:
and should never be omitted.
38 the gentleman's
culty of breathing, — frequent weak, and some-
times intermitting pulse, — the tongue dry, and
covered with a brown fur, — the teeth and
gums being encrusted with the same, — the
forehead is covered with sweat, while the
hands are dry and glow with heat, — the pa-
tient talks wildly.
CAUSES.
Contagion ; grief; whatever tends to weak-
en the system; a poor diet; living in close,
filthy apartments ; inordinate venereal indul-
gences.
DISTINGUISH IT
From putrid fever by the attack coming on
more gradually, and by the greater mildness
of the symptoms, — by the want of those putrid
marks mentioned in the former, and by the ab-
sence of vomiting.
TREATMENT.
If the bowels be costive, give some gentle
laxative, as rhubarb, or six or eight grains of
calomel with as many of jalap. As soon as
this has operated, or even before, (if the weak-
ness of the patient seem to require it) exhibit
wine as freely as the stomach will bear, not
only as a drink, but mixed with his food, which
should be sago, tapioca, panada, jellies, &c. If
no wine is to be had, brandy, and porter (an
important article, when good) are to be freely
employed, always remembering, that if the
strength of the patient be not supported by
these means, he will die of debility. Dashing
MEDICAL VADE-MECUM. 33
cold water over the body, is a remedy in this
disease of great value. If delirium or insensi-
bility come on, shave the head and apply a
blister to it, or cloths wrung out of iced vine-
gar and water. If a purging ensue, it must be
stopped, or it will prove fatal ; this may be
done by the mixture No. 5, and by opium,
which should be given throughout the disease
in liberal doses, every night. The Cayenne
mixture No. 6, musk mixture No. 7, and the
camphor mixture No. 8, will also be found
useful. Great reliance is now placed upon the
sulphate of quinine, which may be taken in
doses of two or three grains, four times a day,
dissolved in a little gum arabic tea, or in pills.
The order of remedies then, in typhus fever,
is, to open the bowels with laxatives, to use
wine, brandy, porter and opium, freely, to dash
cold water over the body, to give chicken wa-
ter, jellies, tapioca, sago, Lc. to check purging,
keep the room cool and clean, use the qui-
nine mixture, one or all of the different mix-
tures of camphor, musk- or Cayenne pepper,
to give opium every night, and if delirium
come on, to apply blisters to the head. Bleed-
ing is at best, a doubtful remedy in typhus,
and should never be allowed without being
ordered by a physician; nine times out often
it is certain death to the patient.
PUTRID FEVER.
SYMPTOMS.
Severe chills, — astonishing and sudden loss
Ol THE GENTLEMAN '-
of strength, — countenance livid, and express
sive of horror anil anxiety, — the skin some-
times burning to the touch, at others the !>e;it
is moderate, — the pulse is quick, small and
hard, — vomiting of bile, — violent pain in the
head, — redness of the eyes, — low muttering
delirium, — the tongue is covered with a dark
brown or black looking crust, — blackish sores
form about the gums, — the breath is very of-
fensive, and in the latter stage, the urine also,
which deposits a dark sediment, — in extreme-
ly bad cases, blood is poured out under the
skin, forming purple spots, and breaks out from
the nose, and different parts of the body, — the
pulse flutters and sinks, hiccup comes on and
death closes the horrid scene.
CAUSES.
Contagion, — the same that produce typhus.
DISTINGUISH IT
From typhus, by the greater severity of all
the symptoms, and by their putrid nature.
From inflammatory fever, by the sudden
weakness, — by the black tongue, — the quick,
small and hard, yet not strong pulse, and by
the marks of putrescency.
TREATMENT.
As severe cases of this disease are apt to run
their career with fatal rapidity, no time should
be lost; bleeding is not admissible, the los< of a
few ounces of blood being equivalent to a sen-
tence of death. A gentle emetic is the first
medicine to be given, which having one rated,
.MEDICAL VADE-MECUM. :>•>
should be followed by a mild purgative ; 6
or 8 grains of calomel, with as many of jalap,
answer the purpose. This being done, re-
sort immediately to the cold water, which
should be dashed over the body, as already
directed. If the weakness of the patient be
such, that fears are entertained of his sinking
under the shock, sponge him with vinegar and
water. When employed early in the complaint
this practice produces the happiest results.
As soon as he is wiped dry, and has taken the
wine if chilled,* give 10 drops of muriatic
acid, with 8 or 9 drops of laudanum, in a* wine
glass of the cold infusion of bark, every four
hours, gradually increasing the quantity of the
acid to twenty drops or more at a dose. Wine
and water should be liberally given in this dis-
ease, as soon as the putrid and typhus symp-
toms show themselves; like every thing else
that is used, it should be taken cold. The sul-
phate of quinine in the same doses as mention-
ed in typhus, is a valuable remedy. Yest, is
much used in putrid fever ; the dose is two ta-
ble spoonsful, every two or three hours, or it
maybe mixed with porter or beer, and taken
in small quantities very frequently.
As a wash for the mouth, nothing is better
than an ounce of alum dissolved in a pint of
water. Rest at night must be procured by
opium, provided there is no delirium. If to-
wards the end of the complaint, there arise
a gentle looseness, accompanied with a moisture
* See rules for the affusion of cold water.
36 the gentleman's
on the skin, that seems likely to prove critical, it
should not be meddled with, but otherwise, ft
must be stopped by astringents, No. 5. As this
is a highly contagious disease, all unnecessary
communication with the sick should be lorbid-
den. The chamber should be kept cool, clean
and frequently sprinkled with vinegar, and all
nuisances be immediately removed. Much ad-
vantage will result from taking the patient, on
the very commencement of the attack, into a
new and healthy atmosphere.
HECTIC FEVER.
This is never a primary disease, but is al-
ways found as a symptom of some other one r
as consumption.
SYMPTOMS.
Night sweats, — bowels costive at first, then
loose, — alternate chills and flushes, — a cir-
cumscribed spot on the cheeks, — a peculiar
delicacy of complexion and emaciation to so
great a degree, that the patient sometimes
looks like a living skeleton.
CAUSES.
The absorption of matter from abscesses, as
in consumption and scrofula.
TREATMENT.
Remove the cause, by curing the disease of
which it is a symptom.
MEDICAL VADE-MECUM. 37
INFLAMMATION OF THE BRAIN.
SYMPTOMS.
Intense pain in the head, — the eyes incapa-
ble of bearing the light,— delirium,— face
flushed, — oppression at the breast, — the pulse
hard, and very rapid, — tongue, at first of a
fiery red, then yellow, brown or black.
CAUSES.
Exposure to excessive heat of the sun, —
blows on the head, — intense application to
study, — intemperance.
DISTINGUISH IT
From inflammatory fever, hy the pulse, which
in the one is full, strong and regular, in the
other, hard, quick and corded, and by the rav-
ing delirium. From typhus, by the two latter
marks.
TREATMENT.
Bleed the patient (as quickly as possible)
■ontil he nearly faints. Upon the resolute em-
ployment of the lancet in the onset, we must
place our chief dependance. The bowels
should be freely opened with Epsom or Glau-
ber salts, the head shaved, and a blister, or
cloths dipped in iced vinegar and water, or
pounded ice, be applied to it, and the room kept
perfectly cool, dark, and quiet. Rice water,
lemonade or cold water, is to be the only diet.
Should the violence of the disease not give
way to these remedies, repeat the bleeding,
blistering, &c. as often as may be necessary
38 the gentleman's
The most vigorous measures to reduce the in-
flammation, are required, or death will be the
consequence.
HEAD-ACH.
CAUSES.
Some particular disease of which it is a
symptom. Indigestion, — a foul stomach, —
tight cravats or shirt collars, — exposure to the
heat of the sun, — a rushing of blood into the
head.
TREATMENT.
This will vary according to the cause. If it
arises from indigestion, that must be attended
to. A foul stomach is one of the most usual
causes of head-ach : such is the connexion be-
tween these parts, that the one is seldom out
of order, without notice being given of it by
the other. In this case, an emetic should al-
ways be administered, which, at a day's inter-
val, is to be followed by a purgative. If from the
beating of the artery in the temples and a sense
of fulness in the head, we suspect it to origin-
ate from an undue determination to that part,
bleed freely, and apply cloths dipped in cold
water to it.
Pains in the head frequently originate from
old venereal complaints; these must be reme-
died by means mentioned in those diseases.
They are also very often caused by gout or
rheumatism; for such cases, see those com-
plaints. Long continued and obstinate head-
MEDICAL VADE-MECUM. 39
ach, has been frequently benefitted by issues
on the back of the neck.
INFLAMMATION OF THE EYE.
SYMPTOMS.
Pain, heat and swelling of the parts, which
appear blood-shot, — the tears hot and scald-
ing, — fever, — -intolerance of light,— some-
times when the lids are affected, the edges
become ulcerated.
CAUSES.
External injuries, as blows, — particles of
sand, &c. getting into them,— exposure to cold,
—a strong light, — intemperance.
TREATMENT.
If the complaint is caused by foreign bo-
dies, they must be removed with the point of
a paint brush, or the end of a piece of wire
covered with lint, or washed out by injecting"
warm milk and water into the eye, with a small
syringe. If particles of iron stick in it, they
may be drawn out by a magnet. From what-
ever circumstance it may originate, the inflam-
mation is to be subdued by bleeding from the
arm, and from the neighbourhood of the eye,
by a dozen or more leeches. The bowels
should be freely opened with Epsom salts, and
a cold lead-water poultice,* enclosed in a
piece of thin gauze, be laid over the part.
The room should be perfectly dark, the
diet extremely low. Any of the lotions No. 9,
* See poultices.
40 THE GENTLEMAN'S
may be used. If the pain is very severe, a
small quantity of equal parts oflaudanum and
water may be dropped into the eye. If the
eye lids are ulcerated, touch them with the
white vitriol ointment. Bathing the eye fre-
quently with clear cold water, is a refreshing
and useful practice.
DIMNESS OF SIGHT.
SYMPTOMS.
The patient imagines he sees particles of
dust, Hies, and cobwebs, floating in the air,
and cannot distinguish clearly any object,
either near to him, or at a distance. Though
the pupil sometimes does not contract, the eye
is to all appearance unchanged.
CAUSES.
Pressure on the optic nerves, within the
scull, by tumours, or other causes, or an error
or defect in the formation of the nerves them-
selves, — drunkenness, — blows on the head, —
apoplexy, — excessive venereal indulgencies.
TREATMENT.
Blisters, issues, or a seton to the back of the
neck,— snuff, by exciting a discharge from the
nose, is of use. Electric sparks passed through
the forehead, and drawn from the eyes, if
persevered in for a considerable time, may
prove effectual. As many causes of this dis-
ease are seated in the intestines and stomach, a
light emetic, may be first given, and then a suc-
cession of purgatives for several days or weeks.
MEDICAL VADE-MECUM. 41
NIGHT BLINDNESS.*
SYMPTOMS,
The sight is perfectly clear and distinct dur-
ing 1 the day, but completely lost at night.
CAUSES.
A diseased liver, — exposure to a strong light.
TREATMENT.
This disease is not common in the United
States ; it is sometimes, however, met with.
The first thing to be done, is to shade the eyes
by a green silk screen, and to avoid any strong
light ; the next, is to bathe the eye very fre-
quently with cold water, or a wash, made by
dissolving twelve or fourteen grains of white
vitriol in four ounces of rose or common water.
Blisters on the temples, placed as close to the
eyes as possible, are highly useful.
INFLAMMATION OF THE EAR.
SYMPTOMS.
Pain in the ear, which at last either gradu-
ally ceases or matter is discharged through the
opening.
CAT -! c .
The accumulation of hard wax, — insects
getting into it, — injuries from blows, &c.
* There are many other discuses incident to the
eyes, but none that can be managed by any but a
physician or surgeon. When, therefore, any altera-
tion in the stricture of ttre eye is perceived, no time
should be lost in having recourse to one or the other.
p 2
42 the gentleman's
treatment.
A little warm olive oil, with an equal part of
laudanum, dropped into the ear, and retained
there by a piece of wool or cotton, will fre-
quently procure almost instant relief. If it be
caused by hard wax, inject warm soap suds or
salt-water to soften it, and then, with care, en-
deavour to extract it, when the oil and lauda-
num may again be employed. In cases of great
severity, a blister may be applied behind the
ear. A temporary deafness frequently resultl
from this complaint, and som 'times, when mat-
ter is formed, the bones of the organ are des-
troyed and hearing is lost forever.
BLEEDING FROM THE NOSE.
CAUSES.
Fulness of blood, — violent exercise, — par-
ticular positions of the body, — blows, &c.
TREATMENT.
Keep the patient erect, or sitting with his
head thrown a little backwards, take off his
cravat, unbutton his shirt collar, and expose
him freely to the cold air; apply ice or cold
vinegar and water to his testicles, and the back
of the neck. If the pulse be full, bleed him
from the arm. If these are not sufficient, moist-
en a plug of linen with brandy, roll it in pow-
dered alum and screw it up the nostril. A ; iece
of cat-gut may, also, be passed through the
nostril into the throat, drawn out at the mouth.
MEDICAL VADE-MECUM. 43
and a bit of sponge be fastened to it and drawn
back again, so as to make tbe sponge block
up the posterior nostril. In doing this it is ne-
cessary to leave a piece of the cat-gut so as
to be got hold of, in order to withdraw the
sponge. It is seldom, however, that the first
remedies will not answer the purpose.
■♦■
POLYPUS.
Tbe nose is subject to two species of this
tumour. The pear-shaped or pendulous poly-
pus, and a flattened irregular excrescence,
which is extremely painful, and is of a cancer-
ous nature. As soon as any affection of this
kind is suspected, apply to a surgeon.
CANCER OF THE LIP.
This kind of cancer always commences in
a small crack, which, after a while becomes
exquisitely painful. If closely examined, this
crack is found to be seated in a small hard
tumour, which soon ulcerates, and if not check-
ed, extends the disorder to the throat, there-
by endangering life.
TREATMENT.
The knife is the only remedy for this as
well as every other species of cancer, and no
time should be lost in resorting to a surgeon.
MERCURIAL ULCERS IN THE MOUTH.
Large, dark looking ulcers in the mouth,
are a common eifect of the use of mercury.
44 the gentleman's
They may be known by the horrid smell of
the breath, by the teeth being loosened from
the gums, and by a coppery taste in the mouth.
TREATMENT.
Omit all mercurial preparations; wash the
mouth frequently with sage tea or vinegar and
water, drink freely of sarsaparilla tea, and
keep the boweis open with sulphur.
ULCERS AND PIMPLES ON THE
TONGUE.
Small pimples are occasionally found on the
tongue, which at last form ulcers. Sometimes
they are occasioned by the rough and project-
ing edge of a broken or decayed tooth : wheri
this is the cause, the part must be rounded by
a file or the tooth extracted, when the sore
will heal without further trouble. Whitish
looking specks, which seem inclined to spread,
are also met with on the inside of the cheeks
and lips. They are easily removed by touch-
ing their surfaces with burnt alum.
CANCER OF THE TONGUE.
Cancer of the tongue commences like that
of the lip, being a crack or fissure in a small,
hard, deep seated tumour on the side of the
tongue.
TREATMENT.
No time should be lost in useless attempts
to cure it by medicines. The only safety for
MEDICAL VADE-MECUM. 45
ihe patien.t is in the knife, and that at an ear-
ly period.
VENEREAL ULCERS.
SEE SYPHILIS.
■ ♦■»
ENLARGEMENT OF THE UVULA.
The uvula is that little tongue-like append-
age that hangs down from the middle of the
fleshy curtain which divides the mouth from
the throat. It is very subject to inflammation,
the consequence of which, is, that it becomes
so long that its point touches, and sometimes
even lies along the tongue, which creates con-
siderable uneasiness, and is now and then the
cause of a constant cough, which finally ends
in consumption. It is commonly called the
falling of the palate.
TREATMENT.
Strong gargles of vinegar and water, or a
decoction of the black oak bark, or a watery
solution of alum, will frequently cure the com-
plaint. It happens very frequently, however,
that in consequence of repeated attacks, it be-
comes permanently lengthened, and then the
only resource is to cut off the end of it. If
you are near a physician apply to him, if not,
the operation is so simple that any man of
common dexterity can perform it, particularly
as little or no blood follows the incision. All
that is requisite, is to seat the patient, seize
46 the gentleman's
the part with a hook, or a slender piair of pin-
cers, draw it a little forward, and snip oft its
point with a pair of scissors.
SWELLING OF THE TONSILS.
The tonsils are two glands situated in the
throat, one on each side, which are very apt
to swell from inflammation by colds. They
sometimes become so large as to threaten
suffocation.
TREATMENT.
In the commencement, this is the same as
directed for inflammatory sore throat, which
see. If it does not succeed, apply to a sur-
geon to take them away.
INFLAMMATORY SORE THROAT.
SYMPTOMS.
Chills, and flushes of heat succeeding each
other, — fever, — the inside of the mouth, the
throat and tonsils much inflamed, — swallowing
is painful, — hoarseness,— heat and darting
pains in the throat.
CAUSES.
Cold, — sitting in damp clothes, — wetfeet, —
excessive exertions of voice.
DISTINGUISH IT
From putrid sore throat by the fever being
inflammatory, &c
MEDICAL VADE-MECUM. 47
TREATMENT.
An emetic, taken at a very early stage of
this disorder, will frequently prevent it from
forming-. The next step is to bleed the patient
freely, and give him a large dose of Epsom salts.
A mustard poultice or blister to the throat, is
an invaluable application, and should never be
neglected. The room should be kept cool
and quiet, and the diet consist of barley or rice
water. The throat may be gargled several
times in the day with No. 10; inhaling the
steam of hot water, from the spout of a tea
pot, is of use. If symptoms of putrescency
appear, treat it as directed in putrid sore
throat.
PUTRID SORE THROAT.
SYMPTOMS.
All the marks of typhus, — on the second
day a difficulty in swallowing, — respiration
hurried, — breath hot, — skin dry and burning,
—a quick, weak and irregular pulse, — scarlet
patches break out about the lips, and the in-
side of the mouth and throat is of a fiery red
colour. About the third day blotches of a dark
red colour make their appearance about the
face and neck, which soon extend over the
whole body. Upon examining the throat a
number of specks, between an ash and a dark
brown colour are observed on the palate, uvu-
la, tonsils, &,c. a brown fur covers the tongue,
— the lips are covered with little vesicles or
48 THE GENTLEMAN*^
bladders, which burst and give out a thin
acrid matter, that produces ulceration wher-
ever it touches. In bad cases, the inside of
the mouth and throat become black, and are
covered with foul spreading ulcers, when all
the symptoms that characterize putrid fever
ensue.
CAUSES.
A peculiar contagion.
DISTINGUISH IT
From scarlet fever, by the fever being a ty-
phus and not inilammatory, by the sore throat,
dark tongue and putrid symptoms.
From measles, by the absence of cough,
sneezing, watering of the eyes, &c.
TREATMENT.
Bleeding in this disease is absolutely forbid-
den. The same may be said of active or strong
purgatives. The bowels, however, should
be kept open by mild laxatives or clysters. If
towards the close of the complaint there is
any obstruction, a few grains of calomel and
rhubarb may be given. Cold water dashed
over the body is one of the most powerful re-
medies we can employ; it should never be omit-
ted ; and as soon as the patient is dried and in
bed, half a pint of strong mulled wine should
be given to him. This practice, boldly follow-
ed, frequently puts an end to the disease.
Emetics are used in the beginning with ad-
vantage, but the great and evident indication,
is to prevent and counteract the disposition to
MEDICAL VADE-MECUM. 49
putrescency, and to support the strength. For
this purpose the cold infusion of bark, or bark
in substance, with ten or twelve drops of ftju-
riatic acid, and eight or nine drops of lauda-
num should be taken frequently, and in large
doses. Cayenne pepper is a valuable article ;
it may be taken in pills, or as recommended
by Dr. Thomas in No. 6. To cleanse the
throat, gargle frequently with No. 11. Any
looseness of the bowels must be checked by
powerful astringents, as No. 5. The diet should
consist of arrow root jelly, panada, tapioca, and
gruel, and the drink, of wine whey, wine and
water, &c. increasing the quantity of the wine
according to the weakness and age of the pa-
tient. The greatest cleanliness is to be ob-
served in the chamber. As this disease is un- \
doubtedly contagious, all unnecessary commu- |
nication with the sick room should be prevent-
ed, and those who are compelled to be with
them, will do well to take a spoonful of the
Cayenne mixture from time to time, by way of
prevention. It is asserted to be a safe-guard
STRICTURES IN THE THROAT.
SYMPTOMS.
The first mark of an obstruction or stricture
in the throat, is a slight difficulty in swallow-
ing solids, which continues increasing for
months, or until the passage becomes so con-
tracted that the smallest particle of food can-
najfllfocia, but. having remained an instant at the
E
60 the gentleman's
strictured part, is violently rejected. If the
obstacle is not removed, the patient starves.
TREATMENT.
Meddle not with the complaint yourself, for
you can do nothing to relieve it, but apply with
all speed to a surgeon, and remember that
your life is at stake.
CATARRH, OR COLD.
SYMPTOMS.
A dull pain in the head, — swelling and red-
ness of the eyes, — the effusion of a thin acrid
mucus from the nose, — hoarseness, — cough, —
fever, &c.
CAUSES.
Cold or damp air, — exposure to wet.
TREATMENT.
If the symptoms be violent, bleed and give
twenty drops of hartshorn in half a pint of
warm vinegar whey. (See No. 12.) Hoarhound
and boneset tea taken in large quantities, are
very useful. The patient should be confined to
his bed, and be freely purged. If there is great
pain in the breast, apply a blister to it. To
ease the cough take a tea spoonful of No. 13,
every 15 minutes, or till relief is obtained.
The influenza is nothing more than an ag-
gravated state of catarrh, and is to be cured
by the same remedies. No cough or cold in
too light to merit attention. Neglected colds lau
the foundation of consumption^ and everu year
send thousands to the grave.
MEDICAL VADE-MECUM. 51
ASTHMA.
SYMPTOMS.
A tightness across the breast, — frequent
short breathing-, attended with a wheezing,
increased by exertion and when in bed. It
comes on in tits or paroxysms.
CAUSES.
Spasm of the lungs.
TREATMENT.
If the cough be violent and frequent, with
great pain in the breast, and the patient be
young and robust, it will be necessary to bleed
him. In old people it should be resorted to
with caution. The tincture of digitalis is
highly recommended in asthma. It should be
taken in doses of a very few drops at first, and
cautiously increased. If the pulse sinks umlcr
it, or giddiness, Sic. is produced, it must be laid
aside. In fact, it is hardly prudent to take this
active and dangerous article, eKcept under a
physician's care. The Indian tobacco may be
safely used in place of it, in doses of a tea
spoonful of the tincture,* every half hour till
relief is obtained. The dried roots of the thorn
apple and skunk cabbage, are sometimes
smoked through a pipe for the same purpose.
Asthma is a disease that is seldom completely
cured by art, nature however, occasionally
effects it.
* Take a sufficient quantity of the leaves, stem
and pods of the plant, put them into a bottle and nil
it up with brandy or spirits, and let it remain for a
few days.
&2 THE GENTLEMAN'S
PLEURISY.
SYMPTOMS.
A sharp pain, or stitch in the side, increased
upon breathing, — inability of lying on the af-
fected side, — pulse hard, quick and corded, —
tongue white.
CAUSES.
Cold — all those that produce inflammation.
TREATMENT.
Take away at once fifteen ounces of blood,
place a large blister over the side and give a
full dose of Epsom salts. Repeat the bleeding
as often as the pulse seems to demand it, and if
expectoration does not come on, apply another
blister close to the first one. All the remedies
for the reduction of inflammation, must be ac-
tively employed. The patient should be con-
fined to his bed, with the head and shoulders a
little elevated, and a warm decoction of the
common hemlock* taken frequently, and in
liberal quantities. The diet should always
consist of rice or barley water.
SPITTING OF BLOOD.
SYMPTOMS.
Blood of a bright red colour, often frothy,
brought up by coughing.
CAUSES.
Consumption and its causes, — a fullness of
blood, — rupture of a blood vessel from any
cause.
* Twigs and leaves of the tree.
MEDICAL VADE-MECUM. S3
DISTINGUISH IT
From vomiting of blood, by its bright colour,
and being brought up with coughing.
TREATMENT.
Give the patient at once a table spoonful of
common salt, and direct him to swallow it.
If the pulse is full, bleed him. The sugar of
lead has much reputation in this complaint : 2
or 3 grains of it, with from a half to a whole
grain cf opium, may be taken every 3 or 4
hours; and in severe cases, where the blood
flows rapidly, 5 or 6 grains, with two of opium,
may be taken at once. The most perfect rest
should be strictly enjoined, and the diet consist
of cold mashed turnips or cold rice water.
CONSUMPTION.
SYMPTOMS.
A short, dry cough, — languor and gradual
io c s of strength, — pulse small, quick, and soft,
— pain in the breast, — expectoration of a
frothy matter, that at last becomes solid and
yellovv,-the breathing grows more anxious and
hurried, — the emaciation and pain encrease, —
hectic fever, — night sweats and a looseness of
the bowels come on, and the patient, unsuspi-
cious of danger, dies.
CAUSES.
Receiving a disposition to the disease from
father or mother, — a flat chest, — spitting of
blood, — neglected colds, — dissipation, Sic.
e2
54 TfTE GENTLEMAN'S
DISTINGUISH IT
By the long continued dry cough, — paw in
the breast, and great emaciation, — by the mat-
ter thrown up being pure pus.*
TREATMENT.
In a confirmed state of consumption, nothing
that art has hitherto been able to do, can ai-
ford us any solid hopes of a cure. When once
the disease is firmly seated in the lungs, all
that is possible, is to smooth the passage to the
grave, and perhaps for a while to retard it. If,
however, the disease is taken in its very bud,
much may be done by a change of climate, a
milk diet, vigorous and daily exercise on horse-
back, and by carefully avoiding cold and all
exciting causes. A removal to a warm climate
should be the first step taken, if practicable : if
not, a voyage to sea, or a long journey on
horseback. A complete suit of flannel, worn
next the skin, is an indispensable article for
every one who is even inclined to this most
fatal disorder. One great blessing, however,
that attends it (and one of its surest marks) is
the unaccountable blindness of the patient to
his own danger. This is sometimes found to
exist even in physicians themselves, and not
five years ago, one of them in its last stage, a
■mere walking skeleton, to my utter amaze-
* In common language, matter. It is known by its
being opaque, mixing with water, and heavier than
it, so that if thrown into a vessel containing that
fluid, it sinks to the bottom. When thrown upon
hot coals it yields an offensive odour.
MEDICAL VADE-MECUM. 55
merit, called on me for a letter ofintroduction
to a friend residing several hundred miles off,
whom he wished to call upon in his journey,
and which he contemplated commencing the
next day. He was at that moment, unable to
stand without assistance, and actually died with-
in twelve hours ! ! !
PALPITATION OF THE HEART.
The s} r mptoms of this complaint must be
obvious from its name. When it arises from
a diseased state of the heart or its vessels,
nothing can be done to cure it. The patient
should be careful to avoid a full habit of body,
and abstain from violent exercise and sexual
indulgences. He should live low, and keep as
quiet and composed as possible. A fit of anger,
or any imprudence, may cost him his life.
There is a milder kind of this disease result-
ing from debility, which must be remedied by
restoring the strength of the general system.
It is also symptomatic of other diseases, and
must be treated accordingly.
DROPSY OF THE CHEST.
SYMPTOMS.
Great difficulty of breathing, which is in-
creased by lying down, oppression and
weight at the breast, — countenance pale or
livid, and extremely anxious, — great thirst, —
pulse irregular and intermitting, — cough, —
violent palpitation of the heart, — the patient
56 TME GENTLEMAN'S
can lie on one side only or cannot lie down at
all, so that he is obliged fo sleep sitting,—
frightful dreams, — a feeling of suffocation, &c.
CAUSES.
Debility. All those producing dropsy in
general.
DISTINGUISH IT
By comparing carefully all the symptoms to-
gether. It is most liable to be confounded with
a diseased state of the heart and its vessels.
TREATMENT.
This is another of those diseases that mock
the art of man. To say it is incurable, would
he hazarding too much, but as yet, it has
nearly always proved so. All th-d cr>n be done
is to follow the same plan that is laid down for
the treatment of dropsy in general, which con-
sists of purging, emetics, and diuretics.* When
the water appears to be confined to one cavity
of the chest, and the oppression cannot be
home, some relief may be obtained by a sur-
gical operation.
INFLAMMATION OF THE STOMACH.
SYMPTOMS.
A fixed burning pain in the stomach. — small,
very quick, hard pulse, — sudden and great
weakness, — the pain in the stomach increased
on the slightest pressure, — vomiting, hiccup.
* Substances that act on the kidneys, producing
an increase of urine.
MEDICAL VADE-MECUM. 57
To these are sometimes added an erysipelat-
ous inflammation, extending from the mouth
to the stomach, — fainting, clammy sweats, and
death.
causes.
Cold suddenly applied to the hody or sto-
mach, — drinking largely of cold water while
very warm. The striking in of eruptions, —
poisons, — gout, — rheumatism.
DISTINGUISH IT
From inflammation of the boin'cls^ hy the seat
of the pain, which is just below tiie breast
bone, in what is called the pit of the stomach,
the burning heat and pain there, — by the hic-
cup and vomiting.
TREATMENT.
As j'ou value the life of the patient, bleed
him quickly, largely, and frequently. The
only safety for him is found in the fearless use
of the lancet. The softness of the pulse, is
here, no rule to go by, — for it, and the convul-
sions are caused by the disease. The rule is
to bleed every few hours till the inflammation
is subdued. From twenty to thirty ounces may
be taken in a full stream from a robust man at
the beginning, and ten more in 6 or C hours,
and so on. As soon as he is bled, or while the
blood is flowing, put him into a warm bath,
and have a large blister prepared, which, alter
he has remained some time in the bath, should
be applied directly over the stomach. A warm
laxative clyster is now to be thrown up, and
58 THE GENTLEMAN
when the stomach will retain it, give him sm&U
quantities of arrow root jelly or gum arable
tea from time to time, with a few drops ol
laudanum. The most rigid diet must he ob-
served, and the patient kept very quirt.
When the inflammation is reduced, and the
stomach will bear it, a grain of solid opium
may be given occasionally with advantage. If
the disease has been brought on by poison
taken into the stomach, apply the remedies
directed in such cases. If mortification ensues,
death is the inevitable consequence. It may
always be expected to take place, when the
lancet has not been freely employed at the
beginning, and known to exist, when from the
state of torture we have just described, there
is a sudden change, to one of perfect ease.
CRAMP IN THE STOMACH.
SYMPTOMS.
Violent spasmodic pain in the stomach,
which is so severe, as nearly to occasion faint-
ing.
CAUSES.
Cold, — gout, — rheumatism, &c. &c.
TREATMENT.
Give 50 or 60 drops of laudanum, in a tea
spoonful of ether, with a little hot wine. Ap-
ply bladders or bottles rilled with warm water
to the stomach and soles of the feet or put
the patient into the warm bath. If the hist
MEDICAL VADE-MECUM. 59
dose of laudanum does not relieve the pain
repeat it.
HICCUPS.
SYMPTOMS.
A spasmodic affection of the stomach and
diaphragm,* producing the peculiar noise
which gives rise to the name.
CAUSES.
Some peculiar irritation.
TREATMENT.
When hiccups occur at the close of any dis-
ease, they may be considered the harbingers of
death, they, however, frequently arise from
acidity in the stomach and other causes. A long
draught of cold water, a sudden surprise or
fright, puts an end to them. A blister over the
stomach may be applied for the same purpose.
I have succeeded in relieving a violent case of
hiccups, that resisted every other remedy, by
the oil of amber, in doses of live drops every
10 minutes. It may be taken in a little mint
water.
HEART-BURN.
This common and distressing affection is
most generally connected with indigestion. To
relieve it for the moment, magnesia, soda or
* A large, broad muscle that closes the chest be-
low, dividing it from the bell}'. It is one of the
agents in respiration.
60 the gentleman's
seltzer water, and water acidulated with sul-
phuric acid, may be employed. To cure the
complaint, requires the digestive powers to be
strengthened by tonics, bitters, and the differ-
ent preparations of iron, &c. as directed for
indigestion. The application of a blister over
the stomach may be of use. The white oxyd
of bismuth in G grain doses, three times a-day,
taken in milk, has been found of service.
INDIGESTION.
SYMPTOMS.
Want of appetite, — low spirits, — pains and
fulness in the stomach, — belching, — a sour wa-
ter rising in the mouth, — heart burn, — the
bowels are irregular and generally costive, —
weakness and emaciation, — pulse small and
slow, — pain in the head, — skin dry, — great
uneasiness after eating.
CAUSES.
All those which induce debility, — excessive
indulgence in the pleasures of the table or in-
temperance in any way,— chewing tobacco, —
a sedentary life, or want of exercise, — a dis-
eased liver.
TREATMENT.
In every case of indigestion, the first thing
the patient should do, is to abstain from what-
ever may have tended to produce it. Chew-
ing and smoking tobacco, occasion a waste of
the saliva that is necessary to the digestive
MKDICAL VAl>E-MECU3f. I /
process — they must be abandoned. The diet
should consist of animal food that is light,
nourishing and easily digested. Roasted mut-
ton is perhaps preferable to any other. Coun-
try air and constant exercise on horseback,
are invaluable remedies in this disease, which
as it is generally occasioned by a departure
from natural habits and employments, must be
relieved by a return to them. Flannel should
be worn next the skin and care taken to avoid
cold or exposure to wet. A wine glass of the
cold infusion of bark and quassia,* with ten or
twelve drops of the elixir of vitriol, should be
regularly taken three times a-day, for months.
The bowels are to be kept open by some warm
laxative, as rhubarb, and the whole frame
braced by the daily use of the cold bath. The
new preparation of bark, called sulphate of
quinine, promises to be of much use in the
complaint of which we are speaking. It must
be taken to the amount of four grains a-day.
in divided doses, either dissolved in water, or
in pills. Weak spirits and water, or a single
glass of sound old Madeira, may be taken at
dinner, but all malt liquors should be avoided.
Much benefit has been found to result from a
long continued use of the wine of iron,t a glass
* Made by placing one ounce of powdered bark
and one of ground quassia in a close vessel, to which
is added a quart of boiling water— to be kept simmer-
ing near the fire until the whole is reduced to a pint.
■\ Take of iron filings four ounces, and pour on it
four pints of Madeira wine, let nfstand for a month*
shaking it frequently.
9
62 The gentleman's
of which may be taken twice a-day. If the
complaint arise from a diseased liver, recourse
must be had to the plan laid down for its cure.
VOMITING OF BLOOD.
SYMPTOMS.
A flow of dark blood from the stomach,
preceded by a sense of weight and oppression
in that organ. The blood is generally mixed
with particles of food, &c.
CAUSES.
Tumours pressing on the liver, blows, &c,
DISTINGUISH IT
From spitting of blood, by its dark colour
and being mixed with food.
TREATMENT.
If the accompanying symptoms be inflam-
matory, bleed, and use some cooling purge :
if otherwise, try thirty drops of the muriated
tincture of iron in a glass of water, every
hour till the bleeding ceases. If the cause
be a diseased liver, or tumour in its neigh-
bourhood, treat it accordingly.
INFLAMMATION OF THE LIVER.
SYMPTOMS.
A dull pain in the right side below the rib,
which is more sensible on pressure, an in-
ability to lie on the left side,— pain in the right
shoulder,*— a sallow complexion. Such are
* This is owing to the course of the phrenic nerve.
MEDICAL VADE-MECUM. 63
the symptoms of an acute attack of this dis-
ease. There is another species of it, called
chronic, in which its approaches are so gradu-
al that it is a difficult matter to determine its
nature. It commences with all the symptoms
of indigestion, and ends in jaundice or dropsy.
CAUSES.
Long continued fever and ague, — inflam-
mation, — acrid bile, — drunkenness or a free
use of spirituous liquors is a very common
cause, — injuries from blows, &c.
DISTINGUISH IT
From pleurisy, by the pain not being so se-
vere ; and by its extending to the top of the
shoulder, — by not being able to rest on the
left side.
TREATMENT.
Bleed the patient according to his age,
strength and the violence of the pain, and if
necessary, apply a blister over the part, which
must be kept open by dressing it with the
savin ointment. The bowels should be opened
by Epsom salts or calomel and jalap. If this
does not abate the symptoms in a few days,
give a calomel pill of one grain every five
hours, or rub a drachm of the strongest mer-
curial ointment into the side until the gums
are found to be a little sore, when the frictions
or pills must be discontinued until the mouth
is well, and then again resorted to as before.
If an abscess points outwardly, apply bread and
milk poultices to the tumour, omit the mer-
64 THE GENTLEMAN'S
cury, use wine, bark and a generous diet. As
soon as matter is to be felt within it, open it
at its lowest and most projecting part with the
point of a sharp lancet, and let out its contents
very slowly, taking care not to close the wound
tiil this is completely effected. The nitric
acid in doses of ten or twelve drops, three
times a-day, gradually increased, and steadily
persevered in, will sometimes produce a cure.
The mercurial plan, however, is to be pre-
ferred.
JAUNDICE.
SYMPTOMS.
Languor, — loathing of food, — a bitter taste
in the mouth, — vomiting, — the skin and eyes
of a yellow colour, — the stools clayey, and the
urine giving a yellow tinge to rags dipped in
it. There is a dull pain in the right side, un-
der the last rib, which is increased by pressure.
When the pain is severe, there is fever. — the
pulse hard and full, &c.
CAUSES.
An interruption to the regular passage of
the bile, which is carried into the blood, — bile
being formed in too great quantities. The first
is occasioned by gall-stones, a diseased liver,
&c. Intemperance is a very common cause,
hence tipplers are more subject to it than
others.
TREATMENT.
If the pulse be full and hard, the pain great
and other intlammatory symptoms be present,
blood is to be taken away as freely as the age
MEDICAL VADE-MECUM. 6b
and strength of the patient, and the violence
of the pain, seems to demand. He should then
be placed in a warm bath, and allowed to re-
main there some time ; when removed to bed,
a grain or two of opium may be given every
few hours until the pain is relieved. Bladders
partly filled with warm water, or cloths wrung
out of hot decoctions of herbs, may also be ap-
plied to the seat of the pain. If the stomach
be so irritable as not to retain any thing on it,
try fomentations and the effervescing mixture,
or a blister to the part. As soon as some de-
gree of ease is obtained* by these means,
purgatives must be employed, and steadily
persevered in ; calomel and jalap or Epsom
salts, in the ordinary doses, answer very well.
The diet ought to be vegetable, and should
the disease have arisen from a neglected in-
flammation of the liver, it must be treated
with mercury. (See inflammation of the liver.)
If putrid symptoms show themselves, meet
them with the remedies already directed for
such cases. Regular exercise, (on horseback,
if possible,) should never be neglected by per-
sons subject to this disease.
* If, however, this cannot be done, and from the
pain being very acute at one particular spot, there is
reason to suppose that a gall-stone is lodged there,
the following remedy may be tried, of which oik- -fifth
or a little less may be taken every morning, drink-
ing freely of chicken broth, flaxseed tea, or barley-
water after it.
Ether three drachms.
Spirits of turpentine two drachms. Mix them
F 2
'JO THE GENTLEMAN'S
AGUE CAKE.
This is the vulgar appellation of an enlarged
spleen, and expresses with much hrief mean-
ing, the cause of the complaint, as it generally
results from ill-treated or obstinate intermit-
tents. It is, however, not productive of much
uneasiness, and frequently disappears of itself.
The plan of treatment if there is acute pain
in the part, is to bleed, purge, and blister. If
it remains enlarged after this, mercury may be
resorted to, as directed in chronic inflamma-
tion of the liver.
INFLAMMATION OF THE INTESTINES.
SYMPTOMS.
Sharp pain in the bowels which shoots round
the navel, and which is increased by pressure, —
sudden loss of strength, — vomiting of dark
coloured, sometimes excrementitious matter,
— costiveness, — small, quick and hard pulse,
— high coloured urine.
CAUSES.
Strangulated ruptures, — cold, — accumula-
tions of hard feces in the bowels, — colic, &c.
DISTINGUISH IT
From ckblic, by the pain being increased by
pressure, whereas in colic it is relieved by it.
TREATMENT.
This is another of those formidable diseases
that require the most actively reducing mea-
sures in the onset. From sixteen to twenty
MEDICAL VADE-MECUM. 61
ounces of blood ought to be taken away at
once,* and the patient placed in a warm bath,
after which a large blister should be applied
to the belly. Emollient and laxative clysters
may be injected from time to time, and if the
vomiting and irritability of the stomach permit
it to be retained, give a large dose of castor oil.
If this be rejected, try the oil mixture No. 14,
or fifteen grains of calomel made into small
pills and taken at once. This, however,
(though one of great importance) is a seconda-
ry consideration. To subdue the inflammation
by large and repeated bleedings, being the great
object. To effect this, if in 5 or 6 hours after
the first bleeding, the pain, kc. be not relieved,
take away ten or twelve ounces more, and so
on till that desirable object is obtained. The
diet should consist of small quant hies of barley
or rice water only. If in the latter stages of
the disease, when the inflammation has some-
what subsided, an obstinate costiveness be found
to resist all the usual remedies, dashing cold
water over the belly will sometimes succeed
Remember that this complaint frequently runs
its course in a day or two, and that unless the
lancet be fearlessly employed in the very begin-
ning, mortification emd death will ensue. It a
strangulated rupture occasion the disease, the
* When certain quantities are mentioned, it is al-
ways to be understood, that they are applicable to
robust men. Common sense will dictate the neces-
sity of dinriniahing tliem, as the patient mavi'all more
or less short of this description.
68 the gentleman's
same, and if possible, still stronger reasons ex-
ist for bleeding, previously to any attempts at
reduction.
CHOLERA-MORBUS, OR VOMITING AND
PURGING.
SYMPTOMS.
A violent vomiting and purging of bile, pre-
ceded by a pain in the stomach and bowels, —
quick, weak and fluttering pulse, — heat, —
thirst, — cold sweats, — hiccups, and sometimes
death in a few hours.
CAUSES.
Exposure to sudden changes of weather-
not wearing flannel, — unripe fruit, — acrid mat-
ters of any kind in the bowels, — cold moist
air, &,c.
TREATMENT.
Wash out the stomach and bowels with co-
pious draughts of chamomile tea, barley or
chicken water, &c. and inject clysters of the
same articles. Bladders or bottles containing
hot water, should be applied to the feet, and
flannel cloths wrung out of hot spirits, be laid
over the stomach. When from the quantity
of barley water, &c. that has been taken, it is
supposed that the stomach is sufficiently clear-
ed, give two grains of solid opium in a pill, and
repeat it every few hours as the case may re-
quire.* If the pill will not remain in the
* If the weakness be very great, and the spasms
go ajarming as to cause a fear of the immediate
medical vade-mecum. 69
stomach, give eighty or ninety drops of lauda-
num, in a table spoonful of thin starch, by
clyster, and repeat it as often as may be ne-
cessary. Fifty or sixty drops of laudanum in
a small quantity of strong mint tea, or the ef-
fervescing draught, will frequently succeed in
allaying the irritation. If all these means fail,
apply a blister to the stomach. When the
violence of the attack is over, give castor oil
or the oil mixture No. 14, to carry off the bile
that may remain in the bowels. To complete
the recovery and to guard against a second at-
tack, a complete casing of flannel is requisite,
together with the use of vegetable bitters and
tonics. Persons subject to this disease, should
be cautious in their diet, and avoid exposure
to moist cold air.
DYSENTERY.
SYMPTOMS.
Fever, — frequent small stools, accompanied
by griping, bearing down pains, the discharge
consisting of pure blood or blood and matter,
sometimes resembling the shreds or washings
of raw flesh, — a constant desire to go to stool,
—vomiting.
CAUSES.
Moist cold air, — unwholesome, putrid food,
— noxious vapours from marshes, &c. — a pe-
culiar and unknown condition of the atmo-
sphere.
result, the quantity of opium may be increased to 6,
8 or 10 grains at a dose.
70 the gentleman's
distinguish it
From a diarrhoea or Zax, by the fever, griping
pains, and the constant desire to evacuate the
bowels, — by the discharge itself being blood,
or matter streaked with blood, &c.
TREATMENT.*
As dysentery or bloody flux is almost always
in this country connected with considerable
inflammation, it will be proper in most cases, to
bleed the patient at the beginning of the at-
tack ; caution, however, is requisite in repeat-
ing the operation, as typhus symptoms some-
times follow it.t Whether it be thought pru-
dent to bleed or not, repeated doses of castor
oil, with clysters of the same, and the appli-
cation of blisters to the belly, should never be
omitted. If there is much vomiting at the
commencement, the stomach and bowels may
be cleansed by barley or rice water taken by
* I have known several cases of dysentery, when
taken in the very beginning', cured in one or two
days by a tree use of the common black-berry sirup.
f Here is an instance of the impropriety of pre-
scribing- for, or treating - diseases, according to their
names. 1 have been called in the same day to two
patients, labouring under this same disease, from one
of whom, (a very robust man, in whom all the marks
of excessive inflammation abounded) it was absolute-
ly necessary to draw blood several times, while the
other was already so reduced, that 1 have no doubt,
had ten ounces of blood been taken from him, it would
have proved fatal. We should always mind the rule
to prescribe for the symptoms and not for the uamz of
a disease.
MEDICAL VADE-MECUM. 7 1
the mouth, and in clysters. As soon as this is
effected, give a grain or two of solid opium ; if
it be rejected, 80 or 90 drops of laudanum in a
table spoonful of chicken broth or starch, by
clyster. The stomach may also be bathed with
a mixture of spirits of camphor and laudanum^
and the irritation reduced by all the means re-
commended for the same symptoms in cholera-
morbus. The diet should consist of gum arabic
dissolved in milk, arrow root jelly, barley
water, &c. Clysters of the same articles, with
the addition of an ounce of olive oil, and twen-
ty drops of laudanum, maybe likewise injected
several times in the day. Towards the latter
end of the complaint, opium and astringents
are proper and indeed necessary, taking care
to obviate costiveness by occasional doses of
castor oil. I say the latter end of it, for in
the commencement they would be hurtful. In
this stage of it also, if a severe tenesmus, (or
constant desire to go to stool) remains, anodyne
clysters will be found useful, or what is more
effectual, a couple of grains of opium placed
just within the fundament. The various as-
tringents which are proper for dysentery h>
its latter stages, are found in Nos. 15, 16, and
17, which may be used with port wine and wa-
ter, as a drink.
DIARRHCEA OR LAX,
SYMPTOMS.
Repeated and large discharges cf a thin ex-
72 the gentleman's
crementitious matter by stool, attended with
griping and a rumbling noise in the bowels.
CAUSES.
Cold, — suppressed perspiration,— acrid mat-
ters in the bowels, — unripe fruit, &c.
TREATMENT.
If the disease arises from cold, a few doses
of the chalk mixture, No. 18, will frequently
put an end to it. It is, however, sometimes
necessary to begin with an emetic of twenty
grains of ipecacuanha, and then open the
bowels by some mild purgative, as castor oil
or rhubarb. Bathing the feet in warm water,
and copious draughts of boneset tea, will be
found of great benefit, if it originate from sup-
pressed perspiration. For the same purpose
also, from 6 to 10 grains of Dover's powder
mav be taken at night, being careful not to
drink any thing for some time after it. If
worms are the cause, treat it as directed. When
it is occasioned by mere weakness, and in the
latter stages of it (proceed from what it may,)
when every irritating matter is expelled, opi-
um, combined with astringents, is necessary as
in the similar period of dysentery. The diet
should consist, in the beginning, of rice, milk,
sago, &c. and subsequently of roasted chicken.
Weak brandy and water, or port wine and
water, may accompany the chicken for a
common drink. Persons subject to complaints
of this kind, should defend their bowels from
the action of cold, by a flannel shirt, the ieet
MEDICAL VADE-MECUM. 73
and other parts of the body, should also be
kept warm.
COLIC.
SYMPTOMS.
Violent shooting pain that twists round the
navel, — the skin of the belly drawn into round
balls, — obstinate costiveness, — sometimes a
vomiting of excrement.
CAUSES.
Cold, — indigestible or acrid food, — wind in
the bowels, — poisons, — gout, — rheumatisms-
worms, &c &c
DISTINGUISH IT
From inflammation of the bowels by the pain
being relieved by pressure, and from other dis-
eases by the twisting round the navel,-— the
skin being drawn into balls, kc.
TREATMENT.
The first thing to be done in this disease is
to give a large dose of laudanum in a little
peppermint water, to open a vein, and apply
a mustard poultice below the navel. Fifty,
sixty or seventy drops of laudanum may be
given at once, as the pain is more or less
violent, and the dose be repeated in a half
hour, or less time, if ease is not procured.
The quantity of blood to be drawn will also
depend on the same circumstance, taking into
consideration the strength of the patient. In
severe cases, 16 ounces may be about the mark
*74 THE GENTLEMAN'S
During this time, if the hist doses of lau Jan una
are found ineffectual in reducing the pain, and
it is very great, eighty or ninety drops may be
given as a clyster in a gill of gruel, or warm
water. One great rule in the treatment of
colic where the pain is excessive, is, to con-
tinue the use of opium in such increased doses
as will relieve it! — When this is obtained,
castor oil by the mouth and clyster must be
employed to open the bowels.
In bilious colic when there is a vomiting
of bile, the effervescing draught, with thirty
drops of laudanum may be taken, to quiet the
stomach, to which, flannels wrung out of warm
spirits may be applied. When the vomiting
has abated, the oil mixture No. 14, or the pills
No. 19, should be taken until a free discharge
is procured. If, notwithstanding our endeav-
ours, the disease proceeds to such an extent as
to induce a vomiting of excrement, the tobac-
co clyster* must be tried, or an attempt be
made to fill the intestines with warm water.
This is done by forcibly injecting it in largo
quantities, at the same time the patient swal-
lows as much as he is able. In this way, with
a proper syringe, two gallons have been suc-
cessfully introduced. In all cases of colic.
when there is obstinate costiveness, an exami-
nation of the fundament should be made with
the finger. If there are any hard, dry pieces,
of excrement there, they may be removed
either by the finger or the handle of* a spoon
* See clyster?
MEDICAL VADE-MECUM. lb
Fhose who are subject to colic, should
avoid fermented liquors, and as much as pos-
sible, vegetable food ; be always well clothed,
and take care not to expose themselves to cold
and wet. The bowels should never be allowed
o remain costive.
PAINTER'S COLIC.
SYMPTOMS.
Pain and weight in the belly, — belching,--
constant desire to go to stool, which is inef-
fectual, — quick contracted pulse, — the belly
becomes painful to the touch, and is drawn in-
to knots, — constant colic pains, — the patient
sits in a bent position, — after a while palsy oi
part, or of the whole body.
CAUSES.
The fumes of lead, or the handling of its
different preparations.
TP-EATMENT.
This disease is but too apt to end in palsy.
leaving the hands and limbs contracted and
useless. In every case of colic, whose symp-
toms resemble the above, if the person has
been exposed to lead in an}' of its shapes, all
doubt on the subject vanishes.
If from the violence of the attack an inflam-
mation of the bowels be feared, bleed accord-
ing to the age, kc. of the patient. Give lau-
danum in large doses, and rub the belly well
with warm spirits, and place him in a bath as
76 the gentleman's
hot as he can bear it. As soon as he is well
dried, and has rested in bed a few minutes,
take him up, and dash a bucket of cold water
over his belly and thighs, or mix an ounce oi
calcined magnesia in a pint of milk, and give
a wine-glassful every half hour, until ease is
obtained. If this, with castor oil by the mouth
and in clysters, will not produce a stool, ap-
ply a large blister to the belly. As soon as
the symptoms are somewhat abated, castor
oil or laxative clysters may be resorted to for
the purpose of keeping the body open ; and
to guard against a return, small doses of
opium should be taken from time to time.
Bitters, the different preparations of iron,
bark, &c. are necessary to restore the strength
of the system. A modern physician of great
eminence, recommends, (in all cases, where
the disease is clearly owing to lead) a salivation,
by rubbing in, on the wrists, night and morn-
ing, one drachm of strong mercurial ointment.
WORMS.
SYMPTOMS.
Intolerable itching at the nose, sometimes
at the fundament, — disagreeable breath, —
grinding of the teeth and starting during sleep,
— hardness of the belly, — gradual emaciation,
—colic, and sometimes convulsions.
CAUSES.
Unknown.
MEDICAL VADE-MECUM. 77
TREATMENT.
This will vary according to the kind of
worm that is to be destroyed. They are of
three kinds:
THE WHITE THREAD WORM
Resembles a small piece of white thread,
and is usually found near the fundament, at
the lower end of the guts, where it produces
a contraction of the parts, and a most intoler-
able itching. Clysters of lime water will fre-
quently bring whole nests of them away, and
procure instant relief. The tincture of aloes,
No. 20, however, is by far the best remedy
known, for not only this, but the round worm.
THE ROUND WORM
Occupies the small intestines, and sometimes
the stomach. It is of various lengths, from 3
to 8 or more inches. If the tincture of aloes
fail to remove it, the pink root may be taken
in decoction, or in powder, in doses of 60 or
00 grains, to be followed after three or four
days by ten or fifteen grains of calomel. Cow-
hage in molasses or honey, with a dose of
castor oil every third day, has been very high-
ly extolled. In cases where all other means
have failed, tobacco leaves pounded with vine-
gar and applied to the belly, have produced
the desired effect*
THE TAPE WORM
Inhabits the whole of the internal canal,
* All the prescriptions No. 22, may be tried in suc-
cession.
*78 THE GENTtEMAN's
and frequently defies all our efforts to get him
out of it. Large doses of spirits of turpentine,
from one to two ounces, in barley water, have
been advantageously employed for this pur-
pose. A remedy formerly much celebrated,
is that of Madame Nouffler, No. 26, after two
doses of which, 15 or 20 grains of jalap with
8 or 10 of calomel should be taken. If the
spirits of turpentine be tried, large quantities
of gruel or barley water should be used with
it, in order to prevent its irritating the stomach
and kidneys.
By whatever means these troublesome
guests are got rid of, the patient should be
careful to strengthen his system and bowels
by a course of bark, bitters, wine, &c. and to
use a great proportion of animal food in his
diet.
INFLAMMATION OF THE KIDNEYS.
SYMPTOMS.
Deep seated pain in the small of the back,
— urine high coloured and small in quantity,
sometimes bloody, — sickness at the stomach,
—vomiting.
CAUSES.
Gravel in the kidneys, — Spanish flies,—
straining the back, — hard exercise by riding,
walking, &c. — cold, — intemperance.
TREATMENT.
This will depend upon the cause. If it
proceed from gravel, the plan to be pursued
MEDICAL VADE-MECUM. 79
will be detailed under that head. If it arise
from any of the others, bleed the patient free-
ly, repeat it in ten or twelve hours, if neces
sary, and put him into a warm bath. Twenty
grains or more of the uva-ursi, with half a
grain of opium three times a-day, accompanied
by small quantities of warm barley or rice
water is one of the most valuable remedies
we are in possession of. The diet during the
attack, should consist of mucilaginous drinks
only, which must be frequently taken, not-
withstanding they may be rejected by vomit-
ing.
GRAVEL.
SYMPTOMS.
A fixed pain in the loins, — numbness of the
thigh, — constant vomiting, — retraction of the
testicle, — urine small in quantity, voided with
pain, and sometimes bloody. As the gravel
passes from the kidney into the bladder the
pain is so acute as to occasion fainting, &,c. &c.
CAUSES.
The formation of a peculiar acid in the
kidneys.
TREATMENT.
Bleed the patient freely, and put him into a
warm bath, where he should remain some
time. Meanwhile an emollient and anodyne
clyster should be got ready, which must be
given to him as soon as he leaves it. Cloths
wrung out of decoctions of herbs or warm
oU THE GENTLEMAN'S
spirits and water, should be applied to the
part, and small quantities of warm gum arabic
tea or barley water be taken frequently. A
grain of opium every two hours, will be found
useful. Strong coffee, without sugar or cream,
sometimes acts like a charm in soothing the
pain : twenty drops of the spirits of turpentine
taken on a lump of sugar every half hour, is
said, by high authority, to do the same. If
the irritation of the stomach is very great,
the effervescing draught, with 30 or 40 drops
of laudanum, may be tried. When the pain, &c.
is somewhat abated, the bowels should be
opened, either with castor oil or Epsom salts.
The uva-ursi, as before mentioned, is one of
the most valuable remedies in all diseases of
the kidneys that we have. Blisters in all such
cases are never to be applied. Persons subject
to this distressing complaint, should be careful
to avoid acids and fermented liquors of all
kinds, including the red wines, beer, pickles,
&c. For a common drink, soft-water, or the
seltzer and soda waters are to be preferred.
When any threatening symptoms are perceiv-
ed, recourse should be had to the uva-ursi, in
small doses of ten or twelve grains, with half
a grain of opium 3 times a-day, to be continu-
ed for weeks.
INFLAMMATION OF THE BLADDER.
SYMPTOMS.
Pain and swelling of the bladder, — the
pain increased by pressure, — a frequent desire
MEDICAL VADE-MECUM. 81
to make water, which either comes away in
small quantities or is totally suppressed.
CAUSES.
Inflammation of surrounding parts, — stone
in the bladder, — suppression of urine.
TREATMENT.
Bleed the patient freely, according to his age
and strength, and put him into the warm bath,
Inject mucilaginous and laxative clysters, and
pursue the exact plan of treatment that is re-
commended for the cause from which it may
proceed. See suppression of urine, Sic.
DIFFICULTY OF URINE.
SYMPTOMS.
A frequent desire to make water, attended
with pain, heat, and difficulty in doing so,— a
fulness in the bladder.
CAUSES.
The urine having been retained too long, —
Spanish flies taken internally, — gravel, — blis-
ters, and all the causes of inflammation of the
bladder — inflamed prostate gland, &c.
TREATMENT.
If it arise from simple irritation by blisters,
&c. plentiful draughts of warm liquids, as gum
arabic or barley water will be sufficient to re-
move it. If from any other cause, a bladder
half filled with warm water, or cloths wrung
out of a warm decoction of herbs, should be
kept constantly applied over the parts, and
mild clysters of thin starch be frequently in-
jecied.
S2 gentleman's
SUPPRESSION OF URINE.
SYMPTOMS.
Pain and swelling of the bladder, — violent
and fruitless attempts to make water, attended
with excruciating pain, &c.
CAUSES.
The same as in a difficulty of urine.
TREATMENT.
As a total suppression of urine is always at-
tended with considerable danger, there should
be no delay in endeavouring to remove it.
The first step is to bleed the patient, who
should immediately after be placed in the
warm bath. While he is there, a laxative
and anodyne clyster must be got ready, which
is to be given as soon as he leaves it, and fre-
quently repeated. In the mean time the warm
fomentations, and bladder of hot water must be
kept applied, and No. 23, be taken every
three or four hours. If there be any difficulty
in procuring it, twenty drops of laudanum in a
little warm barley or rice water, or a decoc-
tion of the dandelion will answer in stead.
Warm sweet oil or milk and water may be in-
jected up the uretha, and 6 or 8 grains of
camphor in a little milk be taken every hour.
If no relief is obtained by these means,
apply snow or ice to the bladder, or make the
patient stand on a cold brick, or stone pave-
ment, am! dash cold water over his thighs, and
if this fail, try the tobacco clyster, which some-
times succeeds after every thing else has been
MEDICAL VADE-MECUM. 83
resorted to in vain. If a catheter* can be pro-
cured, try to pass it into the bladder while in
the bath. If the patient himself cannot do it,t
let a handy friend attempt it ; if foiled in one
position, try another, — success is of the utmost
importance, for there is nothing but an opera-
tion, in the event of its not being obtained that
can save life.
In everj' case of suppression of urine, the
order of remedies then are, blood-letting, — the
warm bdih, laxatives and anodyne clysters, —
fomentations, or bladders half filled with warm
water over the lower belly, camphor and milk
every hour, or JS'o. 30, every three hours, — pass-
ing the catheter, — dashing cold water over the
thighs and legs or applying snow or ice to the
bladder, and lastly, the tobacco clyster.
In the event of a total failure, if the sup-
pression have lastedybwr days, and no surgeon
or physician can be procured,^; puncture the
bladder on the fifth. It is by no means a dif-
ficult thing to do, and as death is the almost
inevitable alternative, it should be attempted.
Just above the yard, at the bottom of the bel-
ly, is a little bony, hairy prominence. In the
middle of the belly and close to the edge of the
bone, is the spot. A very sharp penknife and
a hollow tube, smoothed and rounded at the
edges,§ are all the instruments necessary.
* An instrument used by surgeons to draw oft" the
water from the bladder.
t See directions, Sec. for passing it.
t This may easily happen, particularly at sea.
§ The lower half of a catheter answers verv well.
^4 THE GENtLEMAN's
OPERATION.
Shave the parts, and lay the patient on a
table on his back, feel for the edge of the
bone, and make a cut through the skin, be-
ginning about an inch from the top of the
prominence, and carrying it in a straight line
towards the navel for the length of an inch;
then with short strokes of the knife cut down
through the fat (which is sometimes consider-
able) keeping close to the bone and feeling
with the tip of your finger the distended blad-
der underneath. When you find you are close
to it* plunge the point of the knife into it,
(still keeping near the edge of the bone)
withdraw it immediately and slip in the tube,
which should be kept in for a few days, by
tapes that pass round the body, and then
changed for another of elastic gum. When
the urine flows through the natural passage,
it may be withdrawn and the wound healed.
INCONTINENCY OF URINE.
SYMPTOMS.
An involuntary dribbling or flow of urine.
CAUSES.
A relaxative or paralytic affection of tho
* This may seem a difficult and dangerous attempt.
It is, however, neither the one nor the other. After
a suppression of four or five days, the bladder is so
much enlarged that it sometimes reaches nearly to
the navel, and the peculiar feel of it, no one can
mistake.
MEDICAL VADE-MECUM. 85
bladder,— excessive venereal indulgencies, —
a diseased state of the bladder, — stone in the
bladder.
TREATMENT.
If it arises from a relaxation or weakness of
the parts, use the cold bath daily, apply blis-
ters between the fundament and the bag, and
have recourse to bark and the different to-
nics, as iron, &c. recommended in indigestion.
Twenty or thirty grains of the uva ursi, twice
or three times a-day, with half a pint of lime
water after each dose, may also be tried. If
the disease is occasioned by a palsy of the
parts, the tincture of Spanish dies may be
of service. If a stone in the bladder is the
cause, apply to a surgeon to cut it out. In
the mean time, some kind of vessel should be
attached to the yard, to receive the urine, in
order to prevent it from excoriating the parte.
STONE IN THE BLADDER.
SYMPTOMS.
A frequent desire to make water, which
comes away in small quantities at a time, and
is often suddenly interrupted, the last drops of
it occasioning pain in the head of the yard, —
riding over a rough road, or any irregular mo-
tion, or jolting, causes excruciating pain and
bloody urine, accompanied with a constant de-
file to go to stool, — itching of the fundament,
— a numbness in the thighs, Sic. — retraction
or drawing up of the testicle.
H
86 THE GENTLEMAN S
TREATMENT.
Cutting out the stone, is the only remedy.
DIABETES, OR AN IMMODERATE FLOW
OF URINE.
SYMPTOMS.
Frequent discharges of large quantities of
urine, which is sometimes of a sweet taste, —
skin dry,— bowels costive,— appetite voracious,
— weakness, and gradual emaciation of the
whole body.
CAUSES.
A shattered constitution, — immoderate ve-
nereal indulgencies, — spirituous liquors,-cold,
—suppressed perspiration.
TREATMENT.
The principal remedy for the cure of this
disease, consists in confining the patient to a
diet composed exclusively of animal food.
Blisters may, also, be applied over the kid-
neys and kept open with the savine ointment.
The prescription No. 24,* has proved emi-
nently successful. The carbonate of ammo-
nia, in doses of 11 or 12 grains three times
a-day, is strongly recommended, upon high
authority. In addition to these, opium in li-
beral doses, exercise on horseback, the flesh-
brush, and flannel next the skin are not to be
neglected. The bowels should be kept open
by rhubarb.
* Of Dr. Ferriar, of Manchester, Enriand,
MEDICAL VADE-MECUM. 87
DROPSY OF THE BELLY.
SYMPTOMS.
A swelling of the belly, from water contain-
ed in it, preceded by a diminution of* urine, — ■
dry skin, and oppression at the breast.
CAUSES.
Diseases of various kinds, — intemperance,
— a dropsical disposition.
DISTINGUISH IT
From tympany by absence of the rumbling
of the intestines, belching, colic, and hollow
sound which characterize the latter.
From other diseases, by placing one hand on
the belly, and gently striking it on the opposite
side with the other, when a wavy or tremu-
lous motion will be felt, resembling that occa-
sioned by the agitation of water in a basin.
TREATMENT.
One of the most valuable remedies for drop-
sy is found in the elaterium,* one fourth of a
grain of which is a dose. As it is a most active
article, it is proper to begin with one sixteenth
of a grain daily, which may be cautiously in-
creased to a fourth, or till it is found to exert
its full powers by bringing away large watery
stools. From an ounce to an ounce and a half oi
cream of tartar, dissolved in water, and taken
daily, has frequently succeeded in removing the
complaint. As objections are sometimes made
to the quantity of this latter article, it is neces
♦The dried extract.
28 the gentleman's
sary to use in this way, half an ounce of it,
with one or two grains of gamboge, every
other day, ma_y be substituted for it. Six grains
of calomel, with one or two of gamboge, taken
twice or three times a week, have cured the
disease. Bathing the feet before going to bed,
and taking immediately after 20 grains of
Dover's powder, by producing copious sweat-
ing, has produced the same effect.
Dropsy is, notwithstanding, a difficult disease
to cure. It must be attempted, however, by the
use of such articles as we have mentioned, be-
ginning with the first, and if it fail, proceeding
to the next and so on. If the swelling increases
to such an extent as to be absolutely insup-
portable, send for a surgeon to draw off the
water. At the decline of the disease, the
strength must be supported and restored by
bark, wine and the tonic plan recommended
for indigestion.
TYMPANY.
SYMPTOMS.
The symptoms of tympany or a collection of
air either in the intestines themselves or in
the cavity of the belly, are more or less gra-
dual in their approach. When the disease
lies within the intestines, it commences with
wind in the stomach and bowels, which keeps
up a constant rumbling, belching, &c. — colic,
— costiveness, — diminution of urine, want of
appetite, kc. When it is in the cavity of the
MEDICAL VALL-MiA LM. oL>
belly and outside the intestines, the swelling is
much greater, and very elastic, when it is
struck, giving a hollow sound like a drum, —
there is no belching, &c.
CAUSES.
Weakness of the bowels, — intemperance, —
a vegetable diet.
DISTINGUISH IT
From dropsy, which see.
TREATMENT.
If the complaint is within the intestine*,
keep the nozzle of a clyster pipe up the funda-
ment, to permit the wind to pass through it, in
order to diminish the pressure on the bowels.
Warm mint tea, ginger, horse-radish, ether,
Cayenne pepper, spices and essential oils, with
laxative medicines and clysters, should be free-
ly used, with a moderately tight broad bandage
round the belly. If these means do not answer
the end, warm and active purges must be re-
sorted to, such as the compound tincture of
senna or jalap or any of the Nos. 25, 26, or 27.
If no relief is obtained and the costiveness
continues obstinate, apply pounded ice to the
belly. Rubbing it with turpentine may, also,
prove useful. It is very apt to terminate in
death.
GONORRHOEA, OR CLAP,
SYMPTOMS.
\ tingling sensation at the end of the yard,
90 THE GENTLEMAN'S
%vhich swells, looks red and inflamed, followed
by a discharge of matter that stains the linen,
first of a whitish, then of a yellow or green
colour, — a scalding pain in making water, —
involuntary and painful erections.
TREATMENT.
There are two kinds of this affection, the
mild and the virulent. The first is of so trivial
a nature, that plentiful draughts of any sooth-
ing liquid, as barley water or flaxseed tea, with
a low diet, are sufficient to remove it. The
second produces effects more or less violent on
different persons, and occasionally resists for
months, every remedy that can be thought of.
If there be much pain and inflammation in the
penis, apply a bread and milk poultice to it,
take a dose of salts, and lose some blood. This
is the more necessary if in consequence of the
swelling of the foreskin it cannot be drawn
back,* or being back, cannot be drawn for-
ward.! In the mean time, thirty drops of the
mixture No. 28, should be taken three times
a-day, a very low diet adhered to, and the pa-
tient remain perfectly quiet. Strong injections
at the beginning of a clap, are highly injurious.
If, however, the smarting in malting water be
excessive, No. 29, may be safely employed, at
the end of six or eight days. When the inflam-
mation has somewhat abated, a stronger injec-
tion may be used, as No. 30.
* Technically called a phymosis.
| A para-phymosis.
MEDICAL VADE-MECUM, 9l
A painful incurvation of the yard, called a
chordee, may be relieved by dipping it into
cold water, or surrounding it with cloths soak-
ed in laudanum. To prevent it, take 50 or 60
drops of the latter article on going to bed.
If in consequence of violent exercise, or
strong injections, the testicles swell, confine
the patient on his back, bleed and purge him.
Pounded ice or snow, or cloths dipped in cold
vinegar or water, should also be applied to
the parts, and a very low diet strictly observed.
If, from the same cause, the glands in the
groin are enlarged, treat them in like manner
— — ♦■
GLEET.
SYMPTOMS.
The weeping of a thin glairy fluid, like the
white of an egg^ from the penis, caused by a
long continued clap.
TREATMENT.
A gleet is exceedingly difficult to get rid of,
and frequently defies every effort that is made
for that purpose. It must be attempted, how-
ever, by the daily use of the cold bath, and
30 drops of the muriated tincture of iron, taken
three times a-day, for months, in a glass of the
cold infusion of bark. The injections Nos. 31,
32, or 33, maybe emploj'ed at the same time,
commencing with the first, and if that fail, pro-
ceeding to the second. If after a fair trial of
these means, no relief is obtained, thirty drops
of the tincture of Spanish flies may be taken,
is -x glass of any liquid, three times a-day.
92 the gentleman's
INVOLUNTARY EMISSIONS.
SYMPTOMS.
An involuntary emission of semen during
sleep, inducing great emaciation and debility
CAUSES.
Excessive venery, — onanism, — every thing
ihat weakens the seminal vessels.
TREATMENT.
Abstain from all sexual indulgence and las-
civious ideas or books, — sleep on a hard bed,
— use the cold bath daily, with a generous and
nourishing diet. Chalybeate water and all thfi
different preparations of iron, with the cold
xnfusion of bark and elixir of vitriol, as direct-
ed for indigestion, should be freely employed.
STRICTURES.
SYMPTOMS.
A difficulty in passing water, which instead
of flowing in a full stream, either dribbles
away, twists like a corkscrew, or splits and
forks in two or three directions. They are
occasioned by strong injections, — long con-
tinued or ill treated clap. The cause, how-
ever, is not always to be satisfactorily ascer-
tained.
TREATMENT.
Procure several bougies of different sizes
Take the largest one, dipt it in sweet oil and
pass it into the urethra till it meets with the
MEP1CAL VADE-MECUM. 93
stricture, then make a mark on the bougie, so
that when it is withdrawn, you can tell how
far down the passage the obstruction exists,
and having ascertained this, take the smallest
one, well oiled, and endeavour to pass it* an
inch or too beyond the stricture. If this can be
accomplished, let it remain so a few minutes.
This must be repeated every day, letting the
instrument remain somewhat longer each time
it is passed, and after a few days, using one a
little larger, and so on progressively, until the
largest one can be introduced. If this fails,
apply to a surgeon, who will destroy it with
caustic.
SYPHILIS, OR POX.
SYMPTOMS.
Chancres and buboes, are among the first
symptoms of this dreadful malady, which if not
checked, goes on to cause an ulcerated throat,
nodes, a destruction of the bones and cartil-
ages of the nose, and the palate. The voice is
lost,— the hair falls off,— foul spreading ul-
cers show themselves all over the body, the
stench of which is insupportable, and before he
dies, the miserable victim to it, becomes a
loathsome mass of corruption.
A CHANCRE,
At first resembles a pimple, with a little pit
or depression containing matter, which soon
* See directions for so doing.
94 the gentleman's
becomes an ulcer, with an irregular thickened
edge, covered with a tough, ash-coloured matter,
the basis of which is hard and surrounded by in-
flammation. It is generally found on the fore-
skin or head of the yard.
A BUBO,
Is an enlargement of a gland in the groin,
beginning in a small hard lump, not bigger than
a bean, and increasing to the size of a heris egg.
A NODE,
Is a hard tumour formed on a bone.
TREATMENT.
This is of two kinds, general and local.
The first symptom of pox is generally a chan-
cre, as soon, therefore, as it or any other shows
itself, take immediately one of the pills No. 34,
every morning and night,* and continue to do
so five or six weeks. If they should make the
mouth sore, omit them till it is well, when
they must be resumed as before, and continu-
ed two or three weeks after every symptom
of the disease has disappeared.
* Corrosive sublimate is beyond a doubt, when
properly used, the most mild, safe, and certain pre-
paration of mercury we can employ in this disease.
It is stated on indisputable authority, that of Locher,
of Vienna, that 4880 persons in eight years, were
cured by him, of venereal complaints, by this article,
not one of whom were salivated, died, or experienced
any painful symptom in consequence thereof. Dr.
Hosack, of New York, has also used it, both in public
and private practice, for twenty years, with the most
complete success. It is equally approved of by the
faculty of this city.
MEDICAL VADL-MECU-M. 9i>
*#s for the chancres, touch them with lunar
caustic every few days, and apply a little
piece of rag to them, smeared with red pre-
cipitate ointment. If they are situated under
the foreskin, which is held over the head of
the yard by a permanent phymosis, it (the
foreskin) must be slit up. If there is a bubo,
apply thirty leeches, and then cover it with
several blisters, one after another. If this does
not prevent its increasing, and the formation
of matter is inevitable, apply poultices to it,
and as soon as & fluctuation can be felt, let out
its contents by several small punctures through
the skin, with a sharp lancet. To assist in
the evacuation press a soft sponge gently on
the tumour.
If in addition to buboes and chancres, nodes,
blotches on the skin, and others, or what are
called secondary symptoms are present, par-
ticularly if the case is an old one, the decoc-
tion of guiacum and sarsaparilla should be
employed with the pills. If there be any
objections to the form in which the sublimate
is employed (pills) half a tea spoonful of the so-
lution below,* may be taken morning and
evening, or in very bad cases, a whole one, on
getting up and going to bed.
* Take six grains (accurate weight) of corrosive
sublimate, and dissolve them in three tea spoonsful
of pirits of wine; when thoroughly dissolved, add
twenty-one more of gin. In taking the dose, em-
ploy the same spoon that was used in measuring the
spirits.
96 the gentleman's
There is no occasion whatever, while under
a course of this medicine, to restrict the pa-
tient to the rigidly low diet usually recom-
mended, as nourishing light food that is easily
digested, may always be taken. Spirituous
and fermented liquors, however, are to be
avoided, as well as exposure to cold and wet.
Great cleanliness must be observed.
CANCER OF THE YARD.
SYMPTOMS.
A small tumour like a wart, upon the head
of the yard or foreskin, followed by inflam-
mation and ulceration, which discharges a thin
disagreeable fluid, — after a time, a cancerous
fungus is produced, attended by a most intoler-
able burning and darting pain.
TREATMENT.
Cut out all the diseased parts, without loss
of time. If it be on the head of the yard, ap-
ply at once to a surgeon, who will amputate
it. Death is the only alternative.
VENEREAL WARTS.
Crops of these animal mushroom sometimes
spring up round the head of the yard, or on
the foreskin. If fiat, they may be destroyed
by caustic, if mounted on a stem or foot-stalk,
by tying a piece of thread tightly round it.
MEDICAL VADE-MECUM. 97
MERCURIAL DISEASE.
This is a complaint whose symptoms nearly
resemble the secondary ones of pox, consist-
ing of blotches on the skin, — pains at night,
— ulcers in the mouth, &c. &c. Owing to the
liberal use of calomel, it is now a very common
disease, which is frequently confounded (even
by medical men) with genuine syphilis.
TREATMENT.
Abandon every mercurial preparation, — use
the decoction of guiacum and sarsaparilla, —
the warm bath, and a mild nourishing diet. If
possible, remove to a healthy situation in the
country. It is also necessary to take an oc-
casional purgative of the flowers of sulphur
or of rhubarb.
DROPSY OF THE BAG.
SYMPTOMS.
A collection of water, which is first per-
ceived at the bottom of the bag, increasing in
size as it advances upwards, and forming a tu-
mour of the shape of a pear. If examined as
directed for dropsy of the belly, the wavy mo-
tion may be felt, and if a candle be placed be-
hind it, it becomes partly transparent.
DISTINGUISH IT
From a rupture, by the tumour not swelling
when the patient coughs,— by the tumour ha-
ving commenced at the bottom of the bag, &c.
From a diseased testicle, by its softness, — the
$3 the gentleman's
natural colour of the skin, — abisence of pair^
— transparency, &c. &c.
TREATMENT.
When it is first discovered, attempt to dis-
perse it, by bathing it frequently with No. 35.
The only certain cure, is an operation, for
which, as there is no pressing danger, apply
to a surgeon. There are three species of this
dropsy, in one of which, the water is contain-
ed within the lining of the bag, another with-
in the covering of the spermatic cord, and the
third, in the cellular membrane of the bag.
The first we have mentioned; the second occurs
most frequently in children, it sometimes, how-
ever, is found in adults, and very much resem-
bles a rupture. The treatment is the same
as in the first. The third may be distinguished
by a doughy feel, and irregular shape. It is
to be cured by small punctures with the point of
a lancet, to let out the water, and by suspend-
ing the testicle.
ENLARGED SPERMATIC VEIN.
SYMPTOMS.
A hard knotty and irregular swelling of the
vein, which sometimes increases to a large
size. When lying down, the swelling dimin-
ishes, which distinguishes it from a dropsy of
the parts.
TREATMENT.
Suspend the testicles, or keep the patient
on his back,— apply the lotion No. 35, to the
parts, — the cold bath.
.\i!^mCAL VADE-MECUM. 99
CANCER OF THE TESTICLE.
SYMPTOMS.
The testicle is enlarged, — hardened,— crag-
gy and unequal in its surface, — painful on be-
ing handled, with irregular pains shooting up
the groin, into the back, without any previous
iiiflammation, disease, or external violence.
TREATMENT.
Apply immediately to a surgeon. Castration,
and that at an early stage of the disease, is
the only remedy that can save life. Be care-
ful, however, to distinguish it from simple
swelling of the testicle by inflammation, blows,
&c. Which see.
IMPOTENCY.
This is of three kinds. The first arises
from an original defect in the organs of gene-
ration. The second, from local debility of the
parts, brought on by excessive venery, ona-
nism, or some preceding disease, while the
third originates from fear, excess of passion,
or want of confidence at the moment of coition,
The first is incurable. The second must
be treated by the general principles and re-
medies already pointed out for restoring the
strength of the system, consisting of the cold
bath, preparations of iron, bark, elixir of
vitriol, generous diet, exercise, and by steadi-
ly avoiding the causes which may have pro-
duced it. The remedies for the third, mast
a 00 THE GENTLEMAN'S
be sought for, in calming excessive agitation,
and acquiring by habits of intimacy, that con-
fidence they are sure to produce.
GOUT.
SYMPTOMS.
Pain in the small joints, generally in the ball
of the great toe, — the parts swollen and red,
—the attack coming on in the night. Such
are the striking symptoms of this disease, and
generally the first that are noticed. It is oc-
casionally, however, preceded by all those at-
tendant on indigestion. In the advanced stages
chalky lumps are formed in the joints.
CAUSES.
A too free use of the good things of this
world, — a disposition to it from parents.
DISTINGUISH IT
From rheumatism, by the pain, &c. being in
the small joints, &c.
TREATMENT.
If the patient be young, vigorous, — having
the disease for the first time, bleed and purge
him, confine him to a low diet, and treat it ex-
actly as an inflammation arising from any other
cause. To procure sweating, Dover's pow-
der may be taken on going to bed. As soon
as the inflammation, by these means, is re-
duced, use the cold bath, and take strong exercise
on foot, daily, — avoid high seasoned food, fea-
ther beds, wine, acids and fermented liquors.
-MEDICAL VADE-MECUM. 101
lor the remainder of your life !* Gout is the
child of indolence and intemperance, and to
avoid it, the above means must be employed,
and steadily persevered in.
If, however, the patient is old or infirm,
and subject to regular fits of it, he must not
be handled so roughly. The most perfect
rest should be observed, and the parts lightly
covered with fleecy hosiery, and flannel cloths
wetted with the lotion No. 36, made milk-
warm. The bowels should be opened with
some warm laxative. In a regular fit of the
gout, this is all that can be done. The degree
of warmth that is applied to the part, must be
regulated by the feelings of the patient, who
if wj?y a Hy use a nourishing diet, if strong,
a fcsoif j i cemious one.
It v ny cause, the disease leaves the ex-
tremities and flies to the stomach, apply mustard
poultices and blisters to the soles of the feet
and ankles, — give large doses of ether and
laudanum, hot wine, brandy, &c. and endeav-
our by all such means (including the hot bath)
to send it back again.
If the head be the part it is transferred to,
and apoplexy is produced by it, take away 1 5
* The most perfect and radical cures of gout, have
been effected in luxurious livers, by a sudden change
from soft beds, rich dishes and generous wines, with
nothing at all to do, — to no bed but the bare earth,
black bread and dirty water for meat and drink, and a
powerful inducement to exercise, in the stimulating
application of the whip of" an Algerine slave driver '
i2
102 THE GENTLEMAN'S
or 20 ounces of blood immediately, and give
active purgatives, as 10 or 15 grains of calo-
mel, followed by senna tea or Epsom salts. If
in a few hours, the patient is not relieved,
the head continuing confused and painful, and
the pulse full and throbbing, bleed him again
to the amount of 10 or 12 ounces, and apply
cold vinegar and water constantly to the part.
INFLAMMATORY RHEUMATISM.
SYMPTOMS.
Pain, swelling and inflammation in some one
(or several) of the larger joints. The pain
.shifting from one part to another, — all the
symptoms of fever, — pulse full and %^ r ^, —
tongue white, — bowels costive and urmi Agh
coloured. ^»
CAUSES.
Cold,— suppressed perspiration, — wearing
damp clothes, &c.
TREATMENT.
Bleed the patient freely, or until the pulse
is sensibly affected by it, and purge him with
salts and senna. The Dover's powder should
be taken to procure sweating, and a very
low diet be strictly observed. If the pain con-
tinue severe, and the blood already drawn
shows a yellow or huffy coat, bleed again and
again. The inflammation must be reduced,
and we are not to lay aside the lancet till that
is done. In severe cases, I have known it ne-
MEDICAL VADE-MECUM. 103
cessary to bleed twice a-day, for four or five
days in succession. Active purging with salts
and senna must not be neglected. When the
disease is overcome, if in consequence of the
bleeding, &c. the patient is left very low and
weak, wrap him up in blankets, give him
warm, nourishing food, wine, &c. &c.
CHRONIC RHEUMATISM.
SYMPTOMS.
A chronic rheumatism is nothing more than
one of long standing. It is unaccompanied by
fever, and makes its attacks on every change
of weather, on getting wet, &c. &c. It is fre-
quently caused by inflammatory rheumatism,
and sometimes seems to exist as a primary af-
fection.
TREATMENT.
I have found no one plan of treatment in
this species of the disease, so effectual as the
following : purge with senna and salts, every
other day, — rub the parts well with the linni-
ment No. 37, and use the Cayenne pepper,
and mustard at dinner, in large quantities, and
on going to bed 30 drops of laudanum, with a
tea spoonful of the tincture of guiacum. It is
to be recollected, that this is applicable only
to chronic cases ; if there is fever, &c. it will
do much damage. Should there be any cause
to suspect that a venereal taint is connected
with it, have recourse to the pills No. 34, with
the decoction of guiacum and sarsaparilla. A
104 THE GENTLEMAN S
large blister frequently relieves the whole ot
the symptoms, in the course of a night. The
best safeguard against the complaint is the use
of flannel next the skin, winter and summer.
HIP-JOINT DISEASE.
SYMPTOMS.
Excruciating pain in the hip-joint and knee,
—the leg becomes first longer, then shorter
than its fellow. When lying down the foot
rolls outwards, the buttocks appearing flatter
than usual, — lameness,-after awhile abscesses
In various parts of the thigh,— hectic fever, &c.
CAUSES.
Scrofula.
TREATMENT.
Apply blisters to the part, and if there be
much inflammation, bleed, — make a caustic
issue in the little hollow at the top and out-
side of the thigh, and use all the remedies di-
rected for scrofula. Long continued purging
with jalap and cream of tartar (every other
day) should never be neglected. The diet
should be vegetable, and the limb kept at
rest. When matter is formed, bark, wine, and
a generous diet must be employed. It mostly
proves incurable.
DROPSY OF THE KNEE JOINT.
SYMPTOMS.
The joint swells, the skin remaining of a
MEDICAL VADE-MECUM. 105
natural colour. By placing the hand on one
=ide of it, and striking it gently on the other,
the wavy or fluctuating motion is perceptible,
—steady pressure on one side will raise the
other above its natural level.
CAUSES.
A dropsical disposition, — debility,—— rheu-
matism, — scrofula, — syphilis.
TREATMENT.
Keep a perpetual blister on the joint, or
make a caustic issue below it, on the inside of
the leg, — cold water from the spout of a tea
kettle, is a useful application. Camphorated
mercurial ointment to the knee, and mercury
taken internally, have sometimes been of ser-
vice.
WHITE SWELLING.
SYMPTOMS.
Deeply seated pains in the knee, unattend-
ed at first by swelling, which at last comes on
with increase of pain. After awhile the joint
enlarges, — matter is sometimes discharged, —
hectic fever follows, and cuts off the patient.
CAUSES.
Scrofula, — blows, — inflammation from any
cause.
TREATMENT.
If from scrofula, use the general remedies
directed for that disease, and apply a blister to
the part, which must be kept open by the
I OS THE GENTLEMAN 6
savine ointment, for months : if from blows,
apply the blister as before, bleed and purge
freely, and act as directed in cases of similar
accidents. If in spite of these precautions,
the disease continues to advance, amputation is
the only resource.
PIECES OF CARTILAGE* IN THE
JOINTS.
Portions of cartilage are sometimes formed
in joints, where they act like any other foreign
body of a similar texture. While in the hollows
©f the part, they give no uneasiness, but as
they frequently slip in between the ends of the
bones, causing excruciating pain, it is some-
times necessary to cut them out. For this
purpose apply to a surgeon. As all openings
into the cavities of the joints are attended with
much danger, unless the pain be insupport-
able, it is better to endure the inconvenience
than to run the risk of the operation.
SCROFULA, OR KING'S EVIL
SYMPTOMS.
Hard and indolent swellings of the glands oi
the neck, that when ripe, instead of matter,
discharge a whitish curd. It mostly occurs in
persons of a fair complexion, blue eyes, and
delicate make. In bad cases, the joints swell
with great pain, — the limbs waste away, — the
* Gristle.
MEDICAL VADE-MECUM. 101
ligaments and bones are destroyed, when hec-
tic fever soon relieves the patient from his
misery.
CAUSES.
Inheriting the disease from parents,— moist
cold air, — a poor diet, &c.
TREATMENT.
Sea-water is the great remedy in scrofula.
It is to be used daily as a bath, and a small
portion of it taken internally. Made milk-
warm, it forms one of the most excellent lo-
cal applications that we have. When the
swellings break, a very strong decoction of
hemlock may be advantageously used for the
same purpose. The diet should be mild and
nourishing. Scrofula is seldom, if ever, cured.
After a fair trial, therefore, of the waters of
the ocean, recourse should be had to any new
remedy that may seem to promise relief.
INFLAMED GLANDS.*
Every gland in the body is subject to in-
flammation. Whenever one of them is per-
ceived to be in this state, which may be known
by the swelling and pain, measures should be
taken to reduce it, for fear of its proceeding
to what is called scirrhus, and finally to cancer.
Leeches, blisters, and all the remedies direct-
ed for such purposes, should be actively em-
ployed, among which, purging, bleeding and a
low diet must not be neglected.
* Commonly called kernels
108 THE GENTLEMAN'S
SCIRRHUS.
SYMPTOMS.
A hard tumour, unequal on its surface, and
not very sensible, giving but little or no pain
on being handled.
TREATMENT.
One of the pills No. 34, may be taken three
times a-day, and camphorated mercurial oint-
ment rubbed into the gland. The extract of
cicuta, is a powerful, and sometimes a success-
ful agent in dispersing these swellings. It
should be made into pills of one grain each,
and taken with those of No. 34, beginning
with three pills in the twenty-four hours, and
gradually increasing the number to eight, ten
or twelve in the same time. If it occasion sick-
ness, vertigo, &c. lessen the quantity, or omit
it for a short time.
CANCER.
SYMPTOMS.
A tumour, differing from the preceding one
by being surrounded with enlarged veins. It
is, also, more painful, the skin being sometimes
discoloured and puckered. The whole tumour
is particularly heavy, and at last breaks into a
malignant ulcer or sore, whose edges are
raised, ragged, uneven, and curl over like the
leaves of a flower, — white streaks or bands
cross it from the centre to the circumference.
Acute and darting pains accompany both this
and the preceding stage of the disease.
MEDICAL VADE-MECUM. 109
TREATMENT.
There is but one remedy that can be depend-
ed on for the cure of this painful and inveterate
complaint, and even that should be resorted
to early, in order to ensure success. Ml the
diseased parts must be cut out. Arsenic, corro-
sive sublimate, phosphate of iron, and a thous-
and other articles, have been recommended,
both externally and internally, but without any
effectual advantage. To relieve the pain,
opium may be taken in large doses. A very
low diet (such as is barely sufficient to support
life) of milk and vegetables, will produce the
same effect. The sore should be defended
from the air, by some mild ointment. Pow-
dered chalk, scraped carrots, fresh hemlock
leaves, and powdered charcoal, may be used
for the same purpose.
GOITRE.
SYMPTOMS.
A tumour in the fore-part of the throat,
seated in a gland close to the projection called
" Adam's apple."
CAUSES.
These are not ascertained. They are sup-
posed to consist of some peculiarities in the
water of those places where it is common.
TREATMENT.
Goitre is incurable. When taken at the very
beginning of the complaint, however, and in
110 THE GENTLEMAN'S
young persons, it is said to have been dispersed
by a course of mercury, joined to frictions ol
the part, with strong mercurial ointment. As
it seldom causes any inconvenience, and is al-
ways unattended by pain, it is not a matter of
much consequence. The inhabitants of the
Alps, consider it a mark of beauty, and there
are some Cantons, where every man, woman
and child, is adorned with a tumour of this na-
ture, which they would feel very sorry to be
deprived of. The only remedy that has ever
seemed to be of use, is the burnt sponge No. 38.
It cannot be cut out on account of the great
number of blood-vessels of which it is com-
posed.
FAINTING.
CAUSES.
Sudden and violent emotions of the mind,—
bleeding, — diseases of the heart and its great
vessels.
TREATMENT.
Lay the person on his back, take off his
cravat, then open the doors and windows, and
sprinkle cold water in his face. Smelling salts
may be held to his nose.
APOPLEXY.
SYMPTOMS.
Falling without sense or motion, — profound
sleep, — face livid or flushed, — eyes wide open
MEDICAL VADE-MECUM. Ill
or half closed, and immoveable,— breathing
low, labouring and irregular.
CAUSES.
A rushing of blood to the head, excessive
fat in persons with a short neck, — gluttony, —
violent exercise, — intense heat, — anger,—
hearty meat suppers, — blows on the head, —
intoxication, Sic. &c.
TREATMENT,
If the pulse remains full, — the face flushed,
&c. take away twenty ounces or more of blood
on the spot, remove the cravat, unbutton the
shirt collar, and place the patient in bed, with
his head and shoulders a little elevated. The
windows and doors must be thrown open, and
no more persons than are necessary, be al-
lowed to remain in the room. The head is to
be shaved and cupped, a blister applied to the
back of the neck and the head, and mustard
poultices to the feet. An active purgative*
should always be administered, as soon as the
patient is bled, and its operation assisted by
repeated clysters. If by these means, the
breathing is not easier, and the pulse softer,
bleed again, and again.
If, however, the patient is old and infirm,
and the attack has come on more gradually,
if the pulse is weak, and the face pale, bleed
7/ioderately, and give immediately a warm pur-
gative, apply the blisters, &c. If it arises from
* If the patient cannot swallow pills, try liquids, if
neither, have recourse to a strong purgative clyster.
112 THE GENTLEMAN'S
swallowing vegetable poisons, give an active
emetic, as 30 grains of white vitriol, and act
as directed in cases of similar accidents. In
this second kind of apoplexy, stimulants, as
hartshorn to the nose, &,c. may be used ; in the
first, they are very injurious, and should never
be employed.
STROKE OF THE SUN.
This proceeds from exposure to the sun's
rays, and exhibits the same symptoms as apo-
plexy, commencing with vertigo, loss of sight,
ringing in the ears, &c. and must be treated by
large and repeated bleedings, and in every
other respect as directed for apoplexy.
EPILEPSY.
SYMPTOMS.
A fit, in which the patient falls to the ground
in a convulsion, — the eyes are distorted and
turned up, — hands clenched, — foaming at the
mouth, — convulsions, — the whole ending in a
deep sleep.
CAUSES.
Sudden fright, — anger, — injuries done to
the nerves, — unknown.
TREATMENT.
Keep the patient from hurting himself, by
holding his hands, legs, and particularly his
head, which he is apt to dash violently against
the ground, or surrounding objects. A piece
MEDICAL VADE-MECUM. 113
of soft wood should be placed between his
teeth, to prevent his tongue from being bitten.
This, is in general, all that can be done during
the fit. If, however, there are symptoms of
great determination of blood to the head, bleed-
ing should not be neglected. White vitriol,
the misleto, carbonate of iron, &.c. &c. have
been recommended and tried for the cure of
this complaint, but in vain.
The oxyd of zinc may, however, be tried.
It is taken in pills of a grain each, one three
times a-day, gradually increasing the dose to
five at a time. To reap any benefit from this
medicine, it is necessary to persevere in it for
months. If it fails, steady and long continued
purging should be resorted to. Large doses of
spirits of turpentine, are said to have afforded
relief. The diet, in all cases, should be vege-
table, and if symptoms of fullnes of blood be
present, it will be proper to bleed. Persons
subject to these fits, should never be left alone,
or ride on horseback, for obvious reasons.
PALSY.
SYMPTOMS.
A partial or complete loss of the powers of
motion, and the sensibility of particular parts
of the body, — the pulse soft and slow.
CAUSES.
Apoplexy, — pressure on the nerves, from
blows, wounds, kc. — the fumes of lead.
k %
H4 the gentleman's
TREATMENT.
In a young and robust person, it will be
proper to bleed freely, and give an active
purgative. In old people, or where the pow-
ers of the body are much weakened, warm
laxative medicines with stimulating applica-
tions, as the flesh brush, blisters, mustard poul-
tices, and rubbing the spine with the liniment
No. 37, form the best plan of treatment. If it
affect different parts of the body at once, horse-
radish, mustard, and Cayenne pepper, should
be used liberally, as they are prepared for
table. If a swelling or tumour be found on the
back bone, or any injury has been done to it,
which may have caused the disease, caustic
issues must be placed on each side of it, and
as near the injured part as possible. The diet
should be light and nourishing. The warm
bath must not be neglected.
TETANUS, OR CRAMP.
There are several very long and very learn-
ed names* affixed to this disease, as it may
happen to attack one part of the body or
another. When it is confined to the muscles
of the neck and jaws, locked-jaw, is the com-
mon and expressive term for it. The affec-
tion, however, is always the same, requires
similar treatment, and consists in an involunta-
* Trismus, when confined to the jaws. Opisthoto-
nos, when the hody is bent backwards. Emprostho-
tonos, when it is bent forwards.
MEDICAL VADE-MECUM. 115
ry contraction and stiffening of a part of th<»
muscles, the senses remaining perfect.
LOCKED JAW.
SYMPTOMS.
A stiffness in the back of the neck, which
renders it first painful, and at last impossible to
turn the head round, — difficulty in swallowing,
— pain in the breast shooting to the back,
— the lower jaw becomes stiff, and gradually
closes.
CAUSES.
Wounds, — robust habit of body, — local irri-
tation of a nerve.
TREATMENT.
If the disease is supposed to arise from a
wounded nerve, or from an injury done to
tendinous parts, by a pointed instrument,* en-
large the wound with a sharp lancet, or pen-
knife, and pour laudanum or turpentine into it,
as directed for similar accidents. Blood-letting
to a great extent, is often attended with the
most happy results, and should never be omit-
ted. From a robust man, take 30 or 40 ounces.
This being done, give 2 or 3 grains of opium
at once, and repeat it every two hours, in-
creasing the dose, according to the violence of the
symptoms and the effects produced by it. without
regarding the quantity that has been taken. Cases
are on record, where 60 grains (a drachm)
* As by running a needle into the foot, &c.
1 16 tuf. gentleman's
of solid opium have been taken at once, and
with the happiest effect. This, however, is
a large dose, and should never be ventured on,
but under the most desperate and alarming
circumstances. Active purging with castor
oil and senna tea, must not be omitted, and if
the power of swallowing be lost, laudanum,
&c. must be given in clysters. Drawing a
tooth, is generally recommended by physicians
in those cases where the jaws are firmly
closed, for the purpose of transmitting medi-
cines and food to the stomach. This has al-
ways appeared to me every way calculated to
increase the evil. If no opening exists between
the teeth, access to the bowels can always be
obtained by clysters, and in this way nourish-
ment and remedies may be injected. It is al-
ways proper, however, when the disease is
perceived to be coming on, to place two small
pieces of soft wood between the grinders of
the upper and lower jaw, one on each side,, so
that they may be kept asunder.
Madeira wine, in doses of a wine-glassful
every hour, continued for several days, and
combined with the internal use of mercury
and the warm bath, has been found of great
service. Cold water dashed freely over the
patient, every two or three hours, may like-
wise be tried. After every affusion, he should
be well wiped, and put into a warm bed, when
a large dose of laudanum in warm Madeira
wine, should be given, and the parts rubbed
with the liniment No. 39. The tobacco clys-
MEDICAL VADE-MECUM. 1 1 1
ter* has sometimes succeeded when every
thing else has failed. During the relaxation
which it occasions, opium, wine, &c. must be
freely administered. Blistering the whole
length of the spine, and caustic issues on its
sides, as nearly on a line with the parts affect-
ed as possible, are strongly recommended.
PAINFUL AFFECTION OF THE NERVES
OF THE FACE.
This disease also called tic-doloureux, neu-
ralgia, &c. is of very rare occurrence. As it
is, however, sometimes met with, it is proper
to notice it.
SYMPTOMS.
A very severe pain darting in particular di-
rections, not lasting more than a second, but
very rapidly repeated, and excited by the
slightest touch, — during the intervals, there is
no pain whatever. There is no inflammation
or swelling of the cheek, as in tooth ach, nor
does the pain seem so deeply seated.
TREATMENT.
Blisters, leeches, mercurial ointment, opium
and Fowler's solution of arsenic, with many
* Although a valuable addition to our means of cure,
the tobacco clyster is not to be employed lightly, or
on common occasions. It should always be reserved
to the last moment, never using it until every tiling
else has failed. The prostration of the system, and
other alarming symptoms it sometimes causes, ren-
ders this caution necessary.
1 1 3 THE GENTLEMAN'S
other remedies of the same class, have been
all recommended and used for the cure of this
most painful of all the affections to which the
human body is subject. Where the pains is so
excessive as not to be borne, two grains or
two grains and a half of the extract of bella-
donna, may be taken every three hours. When
the pain is somewhat relieved, this quantity
must be diminished. Mr. Dupre, a French
physician, has lately succeeded in curing this
disease by the sulphate of quinine, his pre-
scription, No. 40, may be tried. If this fails,
apply to a skilful surgeon, who will divide the
nerves.
ANGINA PECTORIS.
SYMPTOMS .
An acute pain at the lower end of the breast
bone, shooting into the left arm, — great diffi-
culty of breathing, — anxiety, — palpitation of
the heart,— a feeling of suffocation. It usual-
ly comes on while ascending a hill, or going
up stairs.
CAUSES.
The vessels of the heart being turned into
bone, — an accumulation of blood in the heart
and its vessels.
TREATMENT.
During the fit, place the patient on his back
and bleed him. If fainting, dash cold water
in his face. Should this not rouse him in a
MEDICAL VADE-MECUM. 119
few minutes, apply a blister to the chest.
Strips of linen, moistened with the solution
below,* applied several times a-day to the
breast bone, for a month, are said to have ef-
fected complete cures. They act by producing
a crop of pimples, on the appearance of which,
the disease declines.
Persons subject to this complaint, should
avoid all fermentable food, and excess in eat-
ing ot drinking, taking care to live quietly,
and to keep the bowels open. Bleeding and
purging, followed by opium, to lessen the
spasm, with the warm bath, and a perpetual
blister or plaster of the tartar emetic oint-
ment to the chest, are perhaps the best reme-
dies that can be employed.
DANCE OF ST. VITUS.
SYMPTOMS.
Irregular and convulsive motions of the
limbs and head, generally of the arm and leg of
one side only. It varies, however, in different
persons, and is frequently counterfeited by
beggars.
CAUSES.
Weakness of the nerves, — worms, — poisons,
— fright, &c.
TREATMENT.
The daily use of the cold bath, with the Pe-
* Tartar emetic, one draclim. Spirits of camphor
half an ounce. Boiling water, one pint. Mix.
! 20 THE GENTLEMAN^
ruvian bark, has often succeeded in curing the
complaint, in young subjects. In addition to
these, any of the preparations of iron No. 41,
combined with large doses of musk, opium,
camphor, &c. may be tried. Active and long
continued purging sometimes produces the
happiest results.
SCARLET FEVER.
SYMPTOMS.
Chills, — heat, — thirst, — head-ach, the
skin is marked with large red or scarlet patch-
es, which at last unite, disappearing in a few
days in a kind of branny scurf, — sore throat.
CAUSES.
A particular contagion.
DISTINGUISH IT
From measles, by the spots coming out on
the second day of the fever. In measles they
seldom appear until the fourth day. By their
colour, which is that of a boiled lobster,
whereas in measles it is of a dark red.
TREATMENT.
An emetic (ipecacuanha) should be given
on the first appearance of the disease, to be
followed by a dose of salts, or eight grains of
calomel, with as many of rhubarb. If the
pulse is full and strong, the head aches, and the
heat great, draw blood, and dash cold water
over the body very freely and frequently. There
is no disease in which the advantages of cold
MEDICAL VADE-MECUM, 121
affusion is more striking. In order to reap
the full benefit of it, however, it must he freely
employed, that is, as often as the heat, &c.
seems to require it, or eight or ten times in
the twenty-four hours. The saline mixture,
No. 1, is of great use. If there is any sore-
ness of the throat, the gargles recommended
for that complaint, should be used, and a mus-
tard poultice be applied to the parts. If symp-
toms of putrescency appear, have recourse to
the plan recommended for putrid sore throat.*
As scarlet fever is undoubtedly contagious, the
usual precautions should of course be adopted.
ERYSIPELAS, OR ST. ANTHONY'S FIRE.
SYMPTOMS.
Fever, — delirium,— vomiting,— pulse strong
or weak, as the fever inclines to the inflamma-
tory or typhus kind, — on the fourth day, some-
times on the second or third, the skin in some
one part, becomes red and inflamed, which is
soon extended to others, — the parts affected
being swollen and of a bright scarlet. If the
face is attacked, it spreads itself on the scalp,
and the eyelids sometimes swell so as to pre-
* Writers on this subject generally consider scarlet
fever as consisting of three kinds, viz : The simple
fever,— the fever with sore throat, and the fever with
putrid sore throat. The treatment of the first, should
be like that of any other inflammatory fever; that of
the second, has been detailed in speaking of inflam-
matory sore throat, and the last, is precisely that of
putrid sore throat.
L
122 the gentleman's
vent the patient from seeing, — after a longer
or shorter period, the eruption ends in small
watery vesicles or blisters, or in branny scales.
At this period, the fever sometimes abates, at
others, drowsiness or delirium comes on, which
increases it, and destroys the patient by the
eleventh day.
CAUSES.
Cold, — excessive heat, — intemperance, —
acrid bile, or other irritating matters in the
stomach and intestines.
TREATMENT.
This disease is of two kinds. One of which
is principally confined to the skin, while the
other affects the whole system. If the accom-
panying fever is inflammatory, bleeding will
be proper, otherwise, not. This operation is
to be cautiously employed in erysipelas, as it
sometimes runs into typhus. If, however, the
patient is robust, his head aches, and great
marks of fulness and inflammation are evident,
which is generally the case in this country,
bleeding, purging with salts, and cooling drinks
should be employed, to which, also, may be
added, Dover's powders, boneset tea, &.c.
to produce sweating. The room should be
kept cool. If, on the contrary, the fever is a
typhus, or unaccompanied by general inflam-
mation, and (as before observed) the patient is
of a weak and irritable habit of body, bleed-
ing should never be resorted to. Opium,
wine, bark, elixir of vitriol, and decoctions of
MEDICAL VADE-MECtJM. 123
the snake root, as recommended for typhus,
are necessary in this case, to guard against
mortification, which sometimes ensues.
As local applications, bathing the parts with
laudanum, or lead water, or dusting them with
rye meal or wheat flour, are the best. Should
the disease evidently be confined to the skin,
the application of a blister will sometimes put
an end to it. If abscesses form, large openings
must be made to let out the matter and dead
parts. When the first or inflammatory kind
prevails, the diet should be barley, sago, pana-
da, &c. with lemonade,* tamarind water, &.C.
for drink. If, on the contrary, when the second,
or typhus form of it (especially if accompanied
by putrid symptoms,) shows itself, a more
generous diet, with a moderate quantity of
wine, &c. must be employed.
MERCURIAL ERYSIPELAS.
SYMPTOMS.
Heat, — redness and roughness, commencing
either in the groin, bag, inside of the thigh,
* It may not be useless again to observe, that in the
United States, erysipelas, nine times out often, calls
for reducing and cooling measures. Among the
various articles which are employed in this, as well as
all inflammatory diseases, none ranks higher in my
mind than lemonade, which should always (if possi-
ble) be made from the fresh fruit. When taken
cold, and in liberal quantities, it is not only delicious
to the palate of the patient, but tends powerfully
to cure his complaint.
124 the gentleman's
or bend of the arm, which slowly and gradu-
ally extend over the whole body, which be-
comes slightly swollen, is tender to the touch,
and itches dreadfully. The roughness is oc-
casioned by small vesicles or blisters contain-
ing a fluid, which at first cannot be seen with-
out a glass, but if not disturbed, acquire the
size of a pin's head. When they are broken,
the matter corrodes the skin wherever it
touches, so that at last, the patient is almost
raw from head to foot. It sometimes occasions
the loss of the hair in every part of the body.
CAUSES.
The excessive use of mercury.
TREATMENT.
Omit all mercurial preparations, — keep the
bowels gently open with Epsom salts, — use
the warm bath frequently, take opium at
night, and dust the parts with flour or starch.
If symptoms of putrescency appear, meet them
with bark, wine, &c.
MEASLES.
SYMPTOMS.
Inflammatory fever,— dry cough and hoarse-
ness, — sneezing, — watering of the eyes, which
itch, — a running from the nose, — great drowsi-
ness. On the fourth day, small red points break
out, first on the face, and then gradually over
the body. They are in clusters, and on pass-
ing the hand over them, are found to be a lit-
MEDICAL VADE-MECUM. 125
tie raised. On the fifth or sixth day the vivid
red is changed to a brown, and the eruption
goes off.
CAUSES.
A particular contagion.
DISTINGUISH IT
From small-pox and all other diseases, by
the dry cough and hoarseness, — by the ap-
pearances of the eyes, which are red, swol-
len, and loaded with tears.
TREATMENT.
The patient must be confined to a low diet,
and kept in bed, with as much covering (but
no more) as may be agreeable to his feelings.
The room should be cool, and if there is much
fever and pain in the head, bleeding is neces-
sary. Should there be pain and oppression at
the breast, apply a blister. The bowels may
be opened by salts. The mild form of measles
ought to be treated like any other inflamma-
tory complaint, taking care, however, not to
repel the eruption by cold. If this happens,
place the patient in a warm bath, give him
warm wine, &c. internally, and apply mustard
poultices and blisters to the feet and ankles.
There is another and more dangerous kind
of this disease, which may be known by the
fever being a typhus, and by all the symptoms
showing a putrid tendency. The moment this
is perceived, have recourse to bark, wine,
muriatic acid, &c. &c. as directed in putrid
fever.
l2
12G the gentleman's
CHICKEN-POX.
SYMPTOMS.
Fever, — inability to sleep,— pain in different
parts of the body, — a crop of small pimples or
points on the back, which by the second day,
are changed into little blisters, which are ripe
on the third and disappear before the fifth day,
without forming true pus or matter, and leav-
ing no marks or pits behind them.
DISTINGUISH IT
From small-pox, by the eruption coming out
on the back, — by the mildness of thefev i\ —
by the fluid contained in the vesicles or blis-
ters not being true pus, and by the whole fall-
ing off in scales on the fifth day.
TREATMENT.
Confine the patient to his bed, — keep him
cool and quiet, and give him a dose of salts.
This is all that is necessary.
»♦»
COW-POX.
SYMPTOMS.
A pimple at the spot where the matter was
inserted, which gradually undergoes certain
regular changes, that characterize the com-
plaint.
CHANGES OF GENUINE COW-POX.
On the second day, or sooner, from the time
of the operation, a small speck of inflamma-
tion is to be perceived, which, on the fourth
day is a pimple, surrounded by a circle of in-
MEDICAL VADE-MECUM. 121
flammation. On the fifths this pimple changes
to a vesicle containing a thin fluid. On the
sixth, this vesicle is more perfect, its margin
forming a regular circle; it is also a little flat-
tened on the top, the centre of which, is of a dark
colour. On the eighth or ninth day, slight
chills, flushes of heat, &c. are sometimes felt,
accompanied by swelling of the pustule, and
pains shooting up into the arm pit, the glands
or kernels of which occasionally swell.
On the tenth or eleventh day, the pustule
is surrounded by a circular, vivid, inflammato-
ry blush that is very beautiful. This is re-
garded as a decisive proof of the presence of
genuine cow-pox. On the eleventh day, the
centre of the pustule begins to grow of a dark
colour, which gradually increases to a brown
or mahogany one by the end of the second
week, when it begins to leave the skin, from
which it is finally separated.
TREATMENT.
If the pain, inflammation aud swelling, are
excessive, reduce them by cold applications,
a dose of salts, low diet, and rest.
OBSERVATIONS.
Notwithstanding the unwearied labours of the
enemies of vaccination, who, since the memo-
rable epoch of 1796. have been, and are still do-
ing all that ignorance and obstinacy can effect to
render this visible interposition of Providence of
as little avail as possible, it is at this moment
confidently relied on by the great body of medi-
cal men in all countries, as a preservative from
128 THE GENTLEMAN S
death by sjr.all-p.ox. As the late alarming epide-
mic with which we have been visited, seems to
have revived the before expiring hopes of its
opposers, and diminished the confidence of some
of its friends, it may not be useless, considering
the immense importance of the subject, to devote
a few words to it.
To those who are unacquainted with the mass
of evidence that is to be found in favour of vac-
cination, I would beg leave to say, examine the
reports of the different colleges, societies, &c. in
all parts of the world, and observe the nature,
respectability, and weight of their contents. You
find one of them declaring that " hundreds of
thousands have been successfully vaccinated in
the British islands ; 800,600 in the East Indies, and
that the practice has extended over all Europe."
*' The security derived from vaccination against
small-pox, if not absolutely perfect, is as much so
as can be expected from any human discovery:"
and again, " there is not nearly so many failures
in a given number of vaccinated persons, as there
are deaths in an equal number of 'persons inocu-
lated for small-pox!!.'" We also have upon ir-
resistible evidence, " towns and districts, in which
vaccination had been general, have afterwards
had the small-pox on all sides of them, without
suffering from the contagion ! !" — " The college,
in reporting their opinions on the evidence ad-
duced in support of vaccination, feel themselves
authorized to state, that a body of evidence so
large, so temperate, and so consistent, was per-
haps never collected before on any medical sub-
ject ! !" Report of the royal college of physi-
cians, London, 1807.
" It is the opinion of your committee, that the
practice of cow-pox inoculation is safe, and fully
answers the purposes that have been intended by
MEDICAL VADE-MECUM. 129
its introduction !" Speaking of cases in which per-
sons are said to have had the small-pox after vac-
cination, it is declared that, " upon minute in-
vestigation, it has been found that these sufifiosed
instances originated in error, misrepresentation,
or the difficulty of discriminating between small-
pox and other eruptive diseases." Report of the
king and queen's college of physicians, Ireland,
1806.
Dr. King, in his work, says " four hundred and
twenty-nine thousand, eight hundred and twenty -
one persons have been successfully vaccinated at
Madras and its dependencies, between Septem-
ber, 1802, and May, 1805 ; two thousand eight
hundred and sixteen of them, were afterwards
inoculated for the small-pox, which they all re-
sist ed .' .'"
To come nearer home, we find it strongly re-
commended, on the highest medical authority
that this country will ever have to boast of, that
of Shippen, Wistar, Rush, Kuhn, Physic, and
fifty-two others, who have publicly proclaimed
it safe and effectual.
Can any one suppose that the learned bodies,
and individuals, above-mentioned, have affixed
their names to declarations so strongly worded,
without being convinced of their truth? or is it
probable that so many men, noted for caution,
and jealous of reputation, could have allowed
themselves to be deceived in a matter like this ?
The page of history, the bills of mortality, the
voice of the intelligent and observing of all classes
of men, answer in one united and overpowering
negative.
Previous to the experiment of Jenner in 1796,
small-pox ravaged cities, and desolated empires :
millions were its prey '. now, those only are its
victims, who are placed beyond the reach of
130 THE GENTLEMAN^
vaccination, or who, by an unaccountable fatuity,
reject its proffered blessings, like men who choose
to shut their eyes against the splendour of the
meridian sun, denying that he shines.
It may be asked, whether in spite of the alarm
created by the varioloid, we may safely trust to
the preventive power of the cow-pox. That
vaccination will always prevent an attack of
small-pox, I am not prepared to assert, (though in
nine cases out of ten, I am fully persuaded, it will
do even that) but of this I am sure, it will pre-
vent the former from killing you ! What is the
difference between varioloid and small-pox i
with the exception of the secondary fever, which
is lighter in the one than the other, they are the
same disease. Instead then of shaking our con-
fidence m the effects of the cow-pox, it ought to
have strengthened it for ever.
The late epidemic was, in fact, genuine small-
pox, and of a most malignant character. Now
the question is, how many died of it ? — But here
and there a tew individuals ! a mere nothing,
when compared to the mass of population con-
stantly exposed to it. Had that population not
been protected — had not vaccination extended
her shield over it, how different must have been
the result! thousands would have been swept
away, and this beautiful city, have added one more
to the already appalling examples of the ravages
of smail-pox, which having once gained an en-
trance to the crowded abodes of man, ne vet-
leaves them until the work of desolation is com-
plete. It is worthy of remark, that while nations
differ in religion, laws, manners, and language,
and will not be persuaded to adopt, those of an-
other, upon the subject of vaccination, they are
all agreed : there being no part of the globe to
MEDICAL VADE-MECUM. 13l
■which it has been introduced, where it is not hail-
ed and cherished as a gift of God.
Under these circumstances, with the concur-
rent testimony of all those who are best qualified
to decide on the subject, and with the emphatic
declaration of the London college before our
eyes, " that in a given number, more persons die
from inoculation for small -pox, than there are
failures from vaccination," what can we think of
him, who, by inoculation, tries to preserve this
fatal leaven ! Public indignation, and the strong
arm of the law should be laid heavily upon him,
— he is a public enemy.
SMALL-POX.
Inflammatory fever, — drowsiness, — pain in
the pit of the stomach, increased by pressure,
— pain in the back, — vomiting, — on the third
day the eruption breaks out on the face, neck
and breast, in little red points that look like
flea-bites, and which gradually appear over
the whole body. On the fifth day, little round
vesicles, filled with a transparent fluid, appear
on the top of each pimple. The eruptive fever
now declines. On the ninth day the pustules
are perfectly formed, being round and filled
with a thick yellow matter, the head and face
also, swelling considerably. On the eleventh
day, the matter in the pustules is of a dark
yellow colour, the head grows less, while the
foet and hands begin to swell. The secondary
fever now makes its appearance. The pus-
132 the gentleman's
tules break and dry up in scabs and crusts,
which at last fall off, leaving pits, which suffi-
ciently mark the cause.
Such are the symptoms of the distinct or
mild small-pox, but it frequently assumes a
more terrible shape, in what is called the con-
fluent. In the latter, all the symptoms are
more violent from the beginning. The fever
is a typhus,— there is delirium, preceded by
great anxiety, — heat,— thirst, — vomiting, &c.
The eruption is irregular, coming out on the
second day in patches, the vesicles of which
are flatted in, neither does the matter they
contain turn to a yellow, but to a brown
colour. Instead of the fever going off on the
appearance of the eruption, it is increased af-
ter the fifth day, and continues throughout the
complaint. The face swells in a frightful man-
ner, so as to close the eyes, — sometimes pu-
trid symptoms prevail from the commence-
ment.
CAUSES.
Contagion.
DISTINGUISH IT
From chicken-pox, which see.
TREATMENT.
Place the patient in a cool airy room, and
let him be but lightly covered with bed clothes.
Purge him every other day with salts, and give
him twenty or thirty drops of laudanum every
night. The diet should consist of panada, ar-
row root, &c. and his drink consist of lemon-
MEDICAL VADE-MECUM. 133
ade or water. If from any cause, the eruption
strikes in, put him into the warm bath, give a
little warm wine-whey, or the wine alone, and
apply blisters to the feet. Obstinate vomiting
is to be quieted by the effervescing draught,
with the addition of thirty drops of laudanum.
In the confluent small-pox, the treatment
must be varied as it inclines more or less to
the inflammatory or putrid type. If it in-
clines to the first, act as directed for the
distinct kind, if to the last, employ all those
means directed in putrid fever. If the eyes
are much affected, it will be necessary to bathe
them frequently with warm milk, and to smear
the lids with some simple ointment.
ITCH.
SYMPTOMS.
An eruption of small pimples between the
fingers, on the wrists, and over the whole
body, which form matter, and are attended
with an intolerable itching.
CAUSES.
Contagion.
TREATMENT.
There are several varieties of this trouble-
some complaint, as the rank, watery, pocky,
scorbutic, &c. A very bad kind of it is con-
tracted by touching dogs that have the mange.
The remedy is sulphur. It should be used in-
ternally with cream of tartar, so as to purge.
M
134 the gentleman's
freely, and at the same time be applied exter-
nally, in the form of an ointment. Equal por-
tions of white vitriol, flour of sulphur, and lau-
rel berries, made into a thin liniment with
olive oil, is highly recommended as a local ap-
plication. The following practice is said to be
effectual. Take of flour of sulphur two ounces,
and mix it well with two drachms of nitre,
throw the mixture into a warming pan con-
taining live coals, and pass the pan between
the sheets in the usual manner. The patient
stripped to his skin, now gets into bed (taking
care not to let the fumes escape) when the
clothes should be tucked in all round him. Re-
peat the process ten or twelve times. The
diet in all cases should be very low.
HERPES.
SYMPTOMS.
Broad itchy spots of a reddish or white co-
lour, breaking out in different places, which
at last run into each other, forming extensive
ulcers, — after a time they become covered
with scales, which fall off, leaving the surface
below red,— while the disease heals in one part,
it breaks out in another.
CAUSES.
Want of cleanliness, — low diet, — living in
low damp situations,— a peculiarity of consti-
tution.
MEDICAL VADE-MECUM. 135
TREATMENT.
The ointment of the oxyd of zinc, is a very
common application. Washing the parts with
a solution of corrosive sublimate in water, one
grain to the ounce, is, however, to be prefer-
red. The citrine ointment may also be tried.
If these fail, apply a strong solution of blue
vitriol to the ulcers, and take a grain of calo-
mel morning and evening. The decoction of
sarsaparilla and guiacum, may be used with
them. If the disease resists the mercury, try
Fowlers solution of arsenic, in doses of five
drops three times a-day, to be cautiously in-
creased as directed for intermitting fevers.
The warm bath should never be neglected in
cutaneous complaints.
SCALD HEAD.
SYMPTOMS.
Inflammation of the skin of the head, which
ends in a scabby eruption that extends o\er
the whole scalp.
CAUSES.
Want of cleanliness, — putting on the hat,
using the comb, or sleeping in the bed of a
person who has it.
TREATMENT.
Shave the head close, wash it well with
warm soap and water, and cover it thickly
with fresh powdered charcoal. One or two
of the pills No. 42, should be taken every
136 rats gentleman's
night, on going to bed. The bowels must be
kept open by magnesia or Epsom salts. If tins
fails, try the citrine or tar ointment to the
parts, with a liberal use of the compound de-
coction of sarsaparilla. The diet should be
wholesome and nourishing, avoiding spirituous
liquors and salted meats. The warm bath
should not be neglected.
RING WORM.
SYMPTOMS.
An eruption running in curved lines, — ge-
nerally in a circle, that itches when rubbed or
when the body is heated.
TREATMENT.
Into one ounce of water, throw more blue
vitriol than it will dissolve, so as to form
what is technically called a saturated solution.
Touching the ulcerated parts with this liquid
several times through the day, will alone fre-
quently cure it. If this fails, apply the citrine
or tar ointments. In very obstinate cases, re-
course may be had to the pills No. 42, or to
the usual doses of Fowlers solution. If it
affects the head, shave it. In this as well as
all other diseases of the skin, the greatest
cleanliness is necessary.
NETTLE-RASH.
SYMPTOMS.
An eruption similar to that caused by the
MEDICAL VADE-MECUM. 1 37
stinging of nettles, whence its name. On rob-
bing the skin which itches, the eruption will
suddenly appear, remain for a moment aod
then vanish, breaking out in some other spot.
The parts affected are swelled, — at one time
presenting the appearance of welts as from
the stroke of a whip-lash, and at another, that
of white solid bumps.
CAUSES.
Supposed to be some irritating matter in the
stomach or bowels.
TREATMENT.
A few doses of Epsom salts, and a little at-
tention to the diet, which should be mild, are
generally sufficient to remove it. If it proceed
from eating poisonous fish, or any unwhole-
some food, take an emetic, &,c. as directed in
such cases.
BLOTCHED FACE.
SYMPTOMS.
An eruption of hard, distinct tubercles or
pimples, generally appearing on the face, but
sometimes on the neck, breast and shoulders.
CAUSES.
A peculiarity of constitution, — irregularity
or excess in eating or drinking.
TREATMENT.
There are a great many varieties of this af-
fection, some of which have been separately
m 2
138 tiik gj n'i ii man's
treated of by WiUa/n and other writers on dis-
eases of the skin, to whom 1 would refer any
one who is particularly interested therein.
Notwithstanding all that has been said on the
subject, there is no disease more difficult to get
rid of than this. Where it arises from sup-
pressed perspiration, high seasoned food, or
intemperance, it may indeed he relieved by
the warm bath, by sweating, purging*, and a
low diet; but when it exists in persons who
have always lead temperate lives, and in whom
it seems constitutional, medicine has but little
effect on it. In all cases, however, the follow-
ing plan may be adopted : take a dose of Ep-
som salts twice or thrice a week, use the
warm bath daily, live on plain, mild food, and
drink nothing hut water. The parts may be
touched frequently with the lotion below.*
If after a fair trial of several months, this shun Id
not succeed, try Fowler's solution, or the pills
N"0. 12, with the decoction of guiacum and sar-
saparilla. The various cosmetics and astringent
applications recommended for these affections,
are always prejudicial, for although they some-
times repress the eruption, they occasion more
severe and dangerous complaints.
SCURVY.
SYMPTOMS.
Bleeding of the gums, — teeth loose, — spots
* Take of corrosive sublimate, four grains ; of spi-
rits of wine half an ounce; when the salt isdissolved,
add of common gin and of water, each three ounces.
MEDICAL VADE-MECUM. 139
of various colours on the skin, generally livid,
•—debility, — countenance pale and bloated, —
pulse small, quick, and intermitting. In its ad-
vanced stage the joints swell, and blood bursts
out from different parts of the body.
CAUSES.
A long exposure to cold moist air, — a diet
consisting exclusively of salted animal food, —
want of wholesome nourishment.
TREATMENT.
Remove the patient to a new and healthy
situation, where the air is dry and pure ; give
him plenty of fresh vegetables, such as spill-
age, lettuce, beets, carrots, and scurvy-grass.
A small proportion of fresh animal food should
be taken with them. This, with oranges, lemons
and sugar, or lemonade, spruce beer with
wine and water, are generally sufficient to
eure the complaint. The nitric vinegar* is
strongly recommended for the same purpose.
If there is much pain in the bowels, laudanum
must be used to relieve it. If the breathing
is difficult, or there is much pain in the breast,
apply a blister to it, for on no account should
blood be drawn in scurvy. A tea spoonful of
charcoal well mixed with half a pint of vine-
gar, forms an excellent gargle to clean the
* It is muck in the following manner. Dissolve
three or four ounces of nitre (saltpetre) in one quart
of vinegar. The close is from half an ounce to an
ounce. If the strength of it occasions any inconve-
nience, add a little water, or diminish the quantity
« >f the dose.
i iO THE GENTLEMAH'B
gums and ulcers in the mouth. Those on the
body, mnv be trashed with the same, or lemon
juice, pure, or mixed with water. The yest
or charcoal poultice, may also be applied to
them with advantage. To restore the tone
of the system, recourse must be had to the
Peruvian bark, with the elixir of vitriol, the
muriated tincture of iron, exercise, &.c. &.c.
■♦■
OF TUMOURS.
By the word tumour is meant a swelling of
any part of the body. They are of different
kinds, arise from various causes, and are more
or less dangerous according to the nature of
their contents and the spot they occupy.
OF RUPTURES.
Ruptures are tumours caused by the provi-
sion of a part of the bowels through certain
natural openings. They are divided into re-
ducible, irreducible, and strangulated. They
mostly occur in men in the groin and bag.
CAUSES.
Straining in any way, as at stool, — vomiting,
— lifting heavy weights, — violent exercise, as
jumping, running, &c. — a natural weakness of
the parts.
REDUCIBLE RUPTURES.
SYMPTOMS.
A small swelling, free from pain, and gene-
MEDICAL VADE-MECUM. 141
rally soft, the colour of the skin over it re-
maining unaltered. While standing up, the
swelling increases, on lying down, it decreases,
the patient being able to return the parts
himself, while in that position. The swelling
is also increased by coughing, sneezing, or
straining as if at stool. If he is flatulent, a
rumbling sensation may be felt in it.
TREATMENT.
The patient should place himself on his back,
with his head and shoulders a little elevated,
draw up his knees to his belly, and (if in this
position, the parts do not return of themselves)
endeavour to push or knead them up into the
belly, through the opening at which they come
out, and which, if the tumour be in the groin
or bag, is an oval ring or slit, in the groin, at
the precise spot where the swelling first ap-
peared. When this is effected, he should re-
main quiet until a truss can be procured, the
spring of which must be passed round his body,
the pad be applied directly over the spot just
mentioned, and held there with one hand,
while the other passes the strap into the buckle
and draws it sufficiently tight. Having done
this, he should get up and walk about. If the
swelling no longer appears, the truss is pro-
perly applied, if otherwise, take it off, return
the parts as before and apply it again ; when, if
on rising, walking about, slightly coughing, &c.
the parts are found to be well kept up, he may
resume his ordinary business. The truss should
be worn night and day, as long as he lives.
142 HIE UENTLEMi
IRREDUCIBLE RUPTURES.*
81 MPT0M8.
A rupture in which there is no pain, yet that
cannot be returned into the belly, caused by
an increased hulk of the parts, or their ha\ Jng
formed adhesions, or grown fast to adjoining
parts.
TRFVI'Ml NT.
A rupture thus situated must he left to itself.
The patient should he extremely cautious in
his diet, and in avoiding costiveness, by the use
of clysters, or if necessary, laxative medicines.
He should also be very careful to protect the
tumour from blows, always recollecting that it
is in danger of strangulation.
STRANGULATED RUPTURES.
SYMPTOMS.
The first mark of a rupture being strangu-
lated, or of pressure being made on it, is cos-
tiveness. The tumour, which before was in-
sensible, becomes painful, the pain being most
severe at the spot where the strangulation or
stricture exists, and extending from thence
across the belly, which becomes swollen and
hard. The pain resembles that which the pa-
* I have seen a rupture of this kind (where the
gut descended into the bag*) which increased to such
a size, that it extended to the knees, forming an oval
tumour of at least seven inches in its shortest diame-
ter. On examination after death, it was found to
contain nearly the whole of the small intestines.
MEDICAL VADE-MECUM. 143
tient would suppose to arise if a cord was
drawn tightly across it. The pain continues
to increase, and is augmented by pressure ;
sneezing, coughing, nausea and vomiting, first
of the contents of the stomach, and afterwards
of the intestines ensue, — great anxiety, — rest-
lessness, and a quick hard pulse. Hiccups,
cold clammy sweats, — weakened respiration,
and a pulse so feeble as hardly to be perceived,
announce the approach or presence of morti-
fication.
TREATMENT.
Lose not a moment in sending for the best
medical aid that may be within reach. In the
mean time, having placed the patient as direct-
ed for reducible ruptures, apply both hands on
the tumour with gentle, but gradually increas-
ing pressure, or grasp the tumour gently but
steadily with one hand, while with the fingers
of the other you endeavour to knead or push
up the parts nearest the ring in the groin,
applying the pressure in the same course the
parts have taken in their descent. If this fails,
seize the tumour between the finger and thumb
of the left hand, close to where it enters the
belly, and carry them downwards, with a mo-
derate pressure, so as to dislodge any excre-
ment which may be there, while with the right
you endeavour to push in the gut.
If you cannot succeed in two or three at-
tempts, place the patient in a -warm bath and
try it again. If still foiled (you have no time
144 the gentleman's
to waste in unavailing attempts) cover the tu-
mour with pounded ice, snow, or any very cold
application. Should this fail, bleed the patient
until he nearly faints, regardless of the small
thready pulse ; if fainting actually occurs, seize
that moment to return the parts, as before di-
rected.
Should the rupture still remain irreducible,
there are but two resources left, the tobacco
clyster, and an operation. One half of the
clyster should be injected; if it occasions sick-
ness and a relaxation of the parts, endeavour
to return them : if the first half does not pro-
duce these effects, throw up the remainder of
it, and when relaxation comes on, endeavour,
as before, to push up the gut. As regards the
operation, no one should ever attempt it but a
surgeon. Large doses of laudanum allay vomit-
ing, and are otherwise beneficial ; in all cases
of this kind, they should never be omitted.
REMARKS.
Ruptures are liable to be confounded with
some other diseases, as dropsy of the bag, en-
larged spermatic vein, &c. The modes of
distinguishing them have already been pointed
out, although it must be confessed that with
respect to the latter, considerable difficulty
exists. If the disease is a rupture, by placing
the patient on his back, returning the tumour
and holding the fingers firmly over the open-
ing, and then desiring him to rise, the swelling
w ill not appear. If, on the contrary, it is an en-
MEDICAL VADE-MECUM. 145
larged spermatic vein, it will be found to be
greater than ever. The latter has also a pecu-
liar ropy feel, as if a bundle of cords were in
the bag.
■♦■
ANEURISM.
SYMPTOMS.
A small tumour without pain or redness, at-
tended by a peculiar throbbing, — it disap-
pears on pressure, and returns the moment it
is removed. As the tumour increases in size,
the throbbing or beating of the artery grows
less perceptible. It is generally found in the
ham, thigh, neck, groin and arm. It is divided
into true and false.
CAUSES,
Of the true are unknown, those of the false
are a wound or rupture of an artery.
DISTINGUISH IT
By the beating or throbbing, which is dimin-
ished by pressing on the artery above the
tumour, and by the latter disappearing on pres-
sure, and returning when it is removed.
TREATMENT.
In the early stage, apply a soft and elastic
cushion to the tumour, and bind it tightly over
it by a bandage. The diet should in ail cases
be extremely low, just sufficient to preserve
life, and no more. If the patient is of a full
habit, he should be bled and purged. This
plan steadily and vigorously pursued for a long
i46 the gentleman's
time, has sometimes effected complete cures.
There is nothing', however, but an operation
that can be depended on, wherefore, as soon as
any swelling of this nature is perceived, no time
should be lost in procuring surgical assistance.
If the tumour is left to itself, it will finally
burst, and death be the inevitable consequence.
FLESHY TUMOURS.
SYMPTOMS.
Small warty projections, which, as they in-
crease in size, drag down the skin from the
neighbouring parts, which forms a kind of stem
or foot-stalk on which the tumour hangs.
They are hard, full of vessels, and are neither
painful nor inflamed.
TREATMENT.
When very small, they may be frequently
touched with caustic, which will destroy them.
If large, the ligature or knife must be employ-
ed, for which purpose have recourse to a sur-
geon.
STEATOMATOUS TUMOURS.
SYMPTOMS.
A small, doughy swelling, which gradually
increases, and sometimes grows to an enormous
size. It is soft and free from pain, — the colour,
of the skin remaining unaltered.
TREATMENT.
These tumours, technically called steatoma-
MEDICAL VADE-MECUM. 147
tous,*are merely inconvenient from their bulk.
They can only be removed by the ligature or
knife, for which purpose apply to a surgeon.
ENCYSTED TUMOURS.
SYMPTOMS.
A distinct, hard, circumscribed swelling, gra-
dually growing larger until a slight inflamma-
tion comes on, when it becomes a little pain-
ful, soon after which, a fluctuation is distinctly
to be perceived. As it progresses the vessels
become enlarged, — it seldom exceeds the size
of an egg.
DISTINGUISH IT
From an abscess by the absence of pain and
inflammation.
TREATMENT.
Pass a seton through the tumour when mat-
ter is formed, or apply to a surgeon to dissect
it out.
GANGLION.
SYMPTOMS.
A small, moveable, elastic swelling, with lit-
tle or no pain, or alteration in the skin, situ-
ated under or between tendons or sinews, and
generally near to a joint, — it sometimes hin-
ders the motions of the part.
CAUSES.
The collection of a fluid within the sheath
of a tendon.
* From a greek word which means suet, the con»
tents of the tumour resembling that substance.
148 the gentleman's
theatmekt.
Apply pressure, blisters, or frictions of strong
camphorated mercurial ointment to the tu-
mour. If these are of no avail, make a small
puncture in it with the point of a sharp lancet,
let out its contents and apply pressure to the
part, so as to make the two sides of the sack
or bag grow together.
BILES.
SYMPTOMS.
A hard, circumscribed, inflamed and very
painful tumour, of a conical shape, seldom ex-
ceeding in size a pigeon's egg.
treatment.
If the patient is of a full habit, bleed and
purge him with Epsom salts. A soft poultice
of warm bread and milk, or rye meal, should
always be applied to the bile, and frequently
changed. If the pain is excessive, a tea spoon-
ful of laudanum may be mixed with each one.
In a few days matter will be formed, when it
may be let out with a sharp lancet.
CARBUNCLE.
A deeply seated, hard, immoveable and cir-
cumscribed tumour, which appears generally
on the back, shoulders, &,c. About the middle
it is of a dark red or purple colour, being much
paler or mottled round its edges. It is attend-
MEDICAL VADE-MECUM. 149
ed with an intolerable itching and burning pain,
and at last becomes a kind of sloughing ulcer,
TREATMENT.
This will depend upon the state of the con-
stitution. Most generally there is great weak-
ness, in which case, the diet must be generous.
Bark, with the elixir of vitriol and opium to
relieve the pain, are to be frequently employ-
ed. As a local remedy, a blister ranks very
high. It should be placed directly on the part.
After being cut, it may be succeeded by a basili-
con plaster. A modern writer strongly recom-
mends the solution of arsenic, as a local reme-
dy in this disease. Pledgets of linen dipped in
the liquor, are to be laid on the swelling, and
frequently renewed. When matter begins to
form, apply a bread and milk poultice, and
treat it in every respect as a common ulcer*
WHITLOW, OR FELON.
SYMPTOMS.
An inflamed tumour at the end of the finger,
It is of three kinds. The first is situated im-
mediately under the skin, around the nail. The
second in the. cellular membrane, the pain and
.swelling of which is much greater than in the
first, and the matter much longer in forming.
The third lies under the sheath or covering of
/the tendons of the fingers, and is infinitely
* For scrofulous and cancerous tumours, goitre,
enlarged glands, H. he see diseases of the glands
B 2
150 the gentleman's
more violent, painful, and dangerous, than
either of the others.
TREATMENT.
If of the first description, open the little ab-
scess with a needle and let out the matter,
which should be prevented from forming, if
possible, by bathing- the part with camphora-
ted spirits. The second should be dispersed
by purging, and by leeches and blisters. If the
inflammation is not reduced by these means,
with a very sharp penknife, make an earl y and
free incision in the middle of the last joint of the
finger down to the bone. Suffer the blood to
run for a few minutes, and then treat it as a
common cut. The same practice should be
followed with regard to the third.
PILES.
SYMPTOMS.
A pain in the fundament when going to stool,
—on examination small tumours arc perceived
to project beyond its verge. They are of two
kinds, the blind and bleeding. They may also
be internal and external.
CAUSES.
Costiveness,— sedentary habits,-aloetic pur-
gatives, — riding on horseback.
BLIND PILES.
TREATMENT.
A diet of rye mush and milk, strictly adhered
to for a length of time, will very frequently
MEDICAL VADE-MECUM. 151
cure the (license. If they project, are swell-
ed and painful, apply twenty or thirty leeches
to them, and cold applications. The common
gall ointment is a very soothing application.
Balsam copaiva in doses sufficiently large to
purge freely, is also highly recommended. A
radical cure, however, is only to be sought
for in the knife or ligature, for which apply to
a surgeon. If the pain is very great, lauda-
num may be taken to ease it.
BLEEDING PILES.
TREATMENT.
If the bleeding is considerable, inject a so-
lution of alum or a decoction of oak bark, or
make pressure upon the vessels by introducing
a sheep's gut, tied at one end, into the funda-
ment, and then filling it with any astringent
fluid by a clyster pipe. This evacuation is
sometimes salutary, and it often requires much
judgment to know if it should be stopped or
not.
OF ABSCESS.
SYMPTOMS.
The formation of matter under the skin, or
in any part of the body, preceded by inflamma-
tion, and marked by a dull heavy weight, —
by the pain becoming more acute and darting,
— by a peculiar throbbing, — by the swelling
\ i-,2 the gentleman's
becoming more elevated and soft to the t<
If the tumour is not opened it bursts.
CAUSES.
Inflammation from injuries, or stimulus ol
any kind.
TREATMENT.
Apply a soft and warm bread and milk, or
linseed poultice to the part, and endeavour to
hasten the formation of matter. When this is
evident, let it out with a sharp lancet. If the
patient is weak, let him have a generous diet
•with wine, porter, bark, &,c.
PSOAS ABSCESS.
A weakness across the loins accompanied
by a dull pain. After a while, the pam shifts
from the back to the thigh and hip, becoming
more darting and severe. The glands in the
groin swell, and at last a soft tumour is per-
ceived at the lower edge of the groin, or by
the side of the fundament, — the swelling in-
creases to a large size, and sometimes extends
itself down the thigh.
CAUSES.
Scrofula,-slraining of the back,-blows, &c
DISTINGUISH IT
From a rupture, by the preceding pain in the
loins, and by the fluctuation.
MEDICAL VADE-MECUM. 153
TREATMENT,
In the early stage, bleed and purge the pa-
tient, keep him on a low diet, and apply a
large blister over the lower part of the back.
Confinement in bed is absolutely necessarj'.
When matter is formed, make an opening into
the tumour in the following manner — push a
sharp lancet first through the s/;m, then oblique-
ly upwards under it, and then by depressing
the point pierce the swelling itself. In this
way the abscess is opened without the danger
that attends wounds of large cavities. If it is
small, the whole of the matter may be allow-
ed to flow away at once, if large, after draw-
ing a pint, close the wound for a few hours
and then finish the operation. The lips of the
wound must be kept together by sticking plas-
ter. As there are many vessels of importance
in the groin, care must be taken to avoid
wounding them, and if a surgeon can be had,
he should always be applied to for this pur-
pose. The disease is said to have been cured
by blistering the tumour, and keeping it open
with the savin ointment.
OF FISTULA.
An abscess or ulcer in the neighbourhood of
the fundament, preceded by an inflamed hard
swelling, which gives much pain. If there is
no communication between the gut and the
154 TtfE GENTLF.MAiN'.-
sore, it is called an incomplete, if there is, a
complete fistula.
TREATMENT.
As the tumour is often taken for piles, atten-
tion should be paid to distinguish them. In all
cases apply forty or fifty leeches to the part,
keep the bowels perfectly loose by a diet of
rye mush, and confine the patient to his bed.
If, however, the formation of matter cannot be
hindered, the swelling must be opened early
and a poultice applied to it, when the disease
occasionally heals like any other sore, but nine
times out of ten it forms a callous winding ab-
scess, through which (if it is complete) excre-
ment, &c. often passes. When it arrives at
this point, nothing but an operation can ever
be of any service.
There is another species of fistulous open-
ing, which follows the obstruction, caused by
strictures, &.c. in the urinary passage. The
water not being able to flow through the na-
tural canal, makes its way out between the
bag and the fundament, constituting what is
called fistula in perineo. It may almost be
called an incurable disease ; at all events, none
but a surgeon can do any thing to relieve it.
OF ULCERS.
By ulcers are meant holes or sores in the
skin and flesh, which discharge matter. They
are divided into inllamed, fungous, sloughing,
and indolent, ulcers in the neighbourhood of
MEDICAL VADE-MECUM. 155
carious bone, and those attended by a peculiar
diseased action.
INFLAMED ULCER.
The margin of the sore is ragged, — the skin
ending in a sharp edge round it. The neigh-
bouring parts are red, swelled and painful, the
bottom of the ulcer is uneven and covered
with a white spongy substance. In place of
healthy yellow matter, it discharges a thin fluid;
the surface of it bleeds on the slightest touch.
TREATMENT.
Confine the patient to bed, bleed and purge
him occasionally, let his diet be extremely low,
and apply a soft bread and milk or linseed
poultice to the ulcer. When healthy yellow
matter is formed, omit the poultice, keep the
sore very clean, and apply a plaster of simple
ointment.
FUNGOUS ULCERS.
SYMPTOMS.
The presence of large round granulations
rising above the level of the adjoining parts,
or what is commonly called proud flesh, marks
this species of ulcer.
TREATMENT.
Sprinkle red precipitate over the proud
flesh, or touch it with lunar caustic, apply
156 the gentleman's
dressings of simple cerate to the sore, and past
a bandage tightly over the whole. Burnt alum
and blue vitriol may also he used to destroy
the proud-flesh. Pressure by a bandage will
often succeed when all other means fail.
SLOUGHING ULCER.
SYMPTOMS.
The death of parts of an ulcer which mor-
tify and fall off, — generally attended by fever
and pain.
TREATMENT.
The diet should be generous, laudanum
must be taken to relieve pain, and bark, wine,
porter, &c. to strengthen the system. The
carrot poultice is the best local application.
The sore may also be washed with equal
parts of a hot decoction of poppy heads, and
spirits of wine. When the dead portions have
all fallen off, treat it as a simple ulcer, paying
attention, however, to the state of the system.
INDOLENT ULCER.
SYMPTOMS.
The edges of the skin are thick, raised,
smooth and shining. The points of new flesh
are flossy, and the appearance of the whole
ulcer is that of an old one in which the heal-
ing process is at a stand.
MEDICAL VADE-MECUM. 1ST
TREATMENT.
Touch the whole surface, sides and edge*
of the sore with caustic, blue vitriol, or pow-
der it with Spanish flies or red precipitate, and
endeavour in this way to rouse the parts to ac-
tion. If one article fails, try another. Strips
of sticking plaster maybe passed over the ul-
cer, about an inch apart, so as to draw its
edges nearer together, and a long bandage be
applied over the whole.
CARIOUS ULCER.
STMPTOMS.
Ulcers situated over or near carious (or
dead) bone, are thereby prevented from heal-
ing, — they frequently penetrate deep into the
parts, forming a canal with hard and indolent
sides, that discharges an offensive unhealthy
matter.
TREATMENT.
Keep the sore clean, repress any proud flesh
that may arise, and pay attention to the gene-
ral health of the patient, taking care that his
strength be kept up, if necessary, by wine,
bark, porter, &,c. &c. The ulcer will not heal
until all the pieces of dead bone are thrown
off. This process sometimes lasts for years, in
which case, patience is the only remedy, and
nature the best physician.
1 58 MEDICAL VADE-MECUM.
ULCERS WITH PECULIAR DISEASED
ACTIONS.
SCORBUTIC ULCER.
SEE SCURVY.
SCROFULOUS ULCER.
SEE SCROFULA.
VENEREAL ULCER.
SEE SYPHILIS.
OF ACCIDENTS,
GENERAL DIRECTIONS.
Whenever a blow has been inflicted—
whether by being thrown from a horse, — out of
a carriage,— by falling from a height, or in any
other way, bleed the patient to the amount of
twelve or fourteen ounces, on the spot, if prac-
ticable, if not, as soon after the accident as
possible. This rule admits of but one excep-
tion, and that is, when the violence has been
so great as nearly to extinguish all the powers
of life, in which case it is proper to wait for
symptoms of returning animation. To hasten
these, a little wine and water, or other stimu-
lus may be given.
If, in consequence of a broken bone or other
injury, the patient is unable to walk, take
a door from its hinges, lay him carefully on it,
and have him carried by assistants to the near-
est house. If no door or sofa can be procured,
two boards, sufficiently long and broad, should
be nailed to two cross pieces, the ends of which
must project about a foot, so as to form handles.
If in the woods, or where no boards can be
procured, a litter may be formed from the
branches of trees. In this way a hand-barrow
may be constructed in a few minutes, on which
the sufferer may be properly carried.
If he has been wounded and bleeds, the bleed-
ing must be stopped before he is removed.
160 thi: gentleman's
Having reached a house, lay him on a bed,
and undress him with care and gentleness. If
any difficulty arises in getting off his coat or
pantaloons, rip up the seams, rather than use
force. This being done, proceed to ascertain
THE NATURE OF THE INJURY.
This may be either simple or compound ;
that is, it may be a contusion or bruise, a wound,
fracture or dislocation, or it may be two or all
of them united in one or several parts.
A contusion is the necessary consequence
of every blow, and is known by the swelling
and discolouration of the skin.
Wounds are self-evident.
Fractures are known by the sudden and se-
vere pain, — by the misshapen appearance of
the limb, — sometimes, by its being shortened,
— by the patient being unable to move it with-
out excruciating pain,— r-but most certainly, by
grasping the limb above and below the spot
where the fracture is supposed to exist, and
twisting it different ways, when a grating will
be felt, occasioned by the broken ends of the
bone rubbing against each other. If the swell-
ing, however, is very great, this experiment
should not be made until it is reduced.
Dislocations or bones being out of joint, are
known by the deformity of the joint when com-
pared with its fellow, — by the pain and inabili-
ty to move the limb, — by its being longer or
shorter than usual, and by the impossibility of
moving it in particular direction?
MEDICAL VADE-MECUM. 161
OF CONTUSION.
If slight, bathe the part frequently with cold
vinegar and water for a few hours, and then
rub it well with brandy, or spirits of any kind.
Should it be very great, or so as to have affected
the whole body, which may be known by a
general soreness, bleed and purge the patient,
and confine him to a diet of rice water, lemon-
ade, panada, Sic. If fever comes on, repeat
the bleeding, purging, &c. In all cases of this
nature, be sure the water is regularly evacu-
ated, for it sometimes happens that in conse-
quence of the nerves of the bladder being pal-
sied by the blow, the patient feels no desire
to pass it, though the bladder be full. If a
suppression ensues, pass a catheter, if possible,
or procure assistance for that purpose.
OF SPRAINS.
Plunge the part sprained into very cold
water, and hold it there as long at a time as
you can bear it — for several hours — then rub it
well with camphorated spirits. If the accident
has happened to a joint, as in the ankle, and
it remains weak, pour cold water on it from the
spout ot'a tea kettle, held at a distance, several
times in the day. The most serious effects,
however, resulting from contusion, is when
the blow is applied to the head, producing
either concussion or compression si' the brahu
o2
1G2 THE GENTLEMAN" 1 :*
CONCUSSION OF THE BRA1IV
SYMPTOMS.
The patient is stunned, — his breathing slow,
— drowsiness, — stupidity, — the pupil of the
eye rather contracted, — vomiting. After a
time he recovers.
TREATMENT.
Apply cloths dipped in cold vinegar and
water to his head, and when the stupor is
gone, hleed him, and open his bowels with
Epsom salts. He should be confined to bed,
kept on a low diet, in a quiet situation, and
every measure taken to prevent an inflamma-
tion of the brain, which, if it comes on, must
be treated by copious bleeding, blisters, &,c.
COMPRESSION OF THE BRAIN.
SYMPTOMS.
Loss of sense and motion,— slow, noisy and
laborious breathing, — pulse slow and irregu-
lar, — the muscles relaxed, as in a person just
dead, — the pupil of the eye enlarged and will
not contract even by a strong light, — the pa-
tient lies like one in an apoplectic fit, and can-
not be roused.
TREATMENT.
Open a vein and draw off sixteen or twenty
ounces of blood, shave the head, and if possi-
ble, procure surgical assistance without delay,
as there is nothing but an operation that can
be of any avail.
MEDICAL VADE-MECUM. 163
OF WOUNDS.
Wounds are of three kinds, viz. incised,
punctured and contused, — among the latter
are included gun-shot wounds. The first step
in all wounds, is
TO STOP THE BLEEDING.
If the flow of blood is but trifling, draw the
edges of the wound together with your hand,
and hold them in that position some time, when
it will frequently stop. If, on the contrary, it
is large, of a bright red colour, flowing in
spirts or with a jerk, clap your finger on the spot
it springs from, and hold it there with a firm
pressure, while you direct some one to pass a
handkerchief round the limb (supposing the
wound to be in one) above the cut, and to tie
its two ends together in a hard knot* A cane,
whip-handle or stick of any kind, must now
be passed under the knot (between the upper
surface of the limb and the handkerchief) and
turned round and round until the stick is
brought down to the thigh,! so as to make
the handkerchief encircle it with considerable
tightness. You may then take off your finger,
if°the blood still flows, tighten the handker-
chief by a turn or two of the stick, until it
ceases. The patient may now be removed
(taking care to secure the stick in its position)
without running any risk of bleeding to death
by the way.
As this apparatus cannot be left on for any
* See plate 1, letter A.
t See plate 1, letter B.
164 the gentleman's
length of lime, without destroying the life of
the parts, endeavour as soon as possible to
secure the bleeding vessels, and take it ofl'.
Having waxed together three or four threads
of a sufficient length, cut the ligature they
form, into as many pieces as you think there
are vessels to be taken up, each piece bring
about a foot long. Wash the parts with warm
water, and then with a sharp hook, or a slen-
der pair of pincers in your hand, fix your eye
steadfastly upon the wound, and direct the hand-
kerchief to be relaxed by a turn or two of the
stick ; you will now see the mouth of the arte-
ry from which the blood springs, seize it with
your hook or pincers, draw it a little out,
while some one passes a ligature round it and
ties it up tight, with a double knot. In this
way take up in succession every bleeding vea-
sel you can see or get hold of.
If the wound is too high up in a limb to np-
ply the handkerchief, don't lose your presence
of mind,* the bleeding can still be command-
ed. If it is the thigk, press firmly in the groin,
— if in the arm, with the hand end or ring ol
a common door key, make pressure above the
collar bone, and about its middle against (he
first rib which lies under it. The pressure is
to be continued until assistance is procured,
and the vessel tied up.
If the wound is on the head, press your
finger firmly on it, until a compress can be
• A little practice on himself or others, would soon
enable any one to compress the great arteries in those
two situations. And it is well worth the time spent
MEDICAL VADE-MECUM. 1G6
brought, which must be bound firmly over the
artery by a bandage. If the wound is in the
face, or so situated that pressure cannot be
effectually made, or you cannot get hold of
the vessel, and the blood flows fast, place a
piece of ice directly over the wound, and let it
remain there till the blood coagulates, when it
may be removed and a compress and bandage
be applied.*
INCISED WOUNDS.
By an incised wound, is meant a clean cut
Having stopped the bleeding, wash away all
dirt, &c. that may be in it with a sponge and
warm water, then draw the sides of the wound
together, and keep them in that position by
narrow strips of sticking plaster, placed on at
regular distances, or from one to two inches
apart. A soft compress of old linen or lint
may be laid over the whole.
in doing so. Many a man has bled to death before
a surgeon could be procured, although surrounded
with persons, who by the simple process above-
mentioned, might have preserved him.
t In a moment of great confusion, during the
night, being without instruments or assistants, and
with hardly any light, I once completely succeeded
by this simple application, in arresting a very danger-
ous hemorrhage from a vessel as large as a crow
quill. The wound healed without any secondary
bleeding, nor was a ligature subsequently applied to
the artery, although on removing the dressings, its
divided end could be distinctly seen, plugged up by
a coagulum of blood, and vibrating with every stroke
of the hear
166 tiik gentlemam's
Should much inflammation follow, remove
the strips, bleed and purge the patient (who
should live very low and be kept perfectly
quiet) according to the exigency of the case.
If it is plain that matter must form before the
wound will heal, apply a soft poultice until
that event takes place, when dressings of some
simple ointment may be substituted for it.
Although narrow strips of linen, spread with
sticking plaster, form the best means of keep-
ing the sides of a wound together, when they
can be applied, (see plate 1, letter E) yet in
the ear, nose, tongue, lips, bag and eye lids, it
is necessary to use stitches, which are made in
the following manner. Having armed a com-
mon needle with a double waxed thread, pads
the point of it through the skin, at a little
distance from the edge of the cut, and bring it
out of the opposite one, at the same distance.
(Plate 1, letter G.) If more than one stitch is
required, cut off the needle, thread it again,
and proceed as before, until a sufficient num-
ber are taken, leaving the threads loose (pi. 1,
letter F) until all the stitches are passed, when
the respective ends of each thread must be
tied in a hard double knot, (plate 1, letter II)
drawn in such a way that it bears a little on the
side of the cut. When the edges of the wound
are partly united by inflammation, cut the knots
carefully and withdraw the threads.
From what has been said, it must be evi-
dent, that in all wounds, after arresting the
flow of blood and cleansing the parts, if neces-
sary, the great indication is to bring their sides
MEDICAL VADE-MECUM, 16?
into contact throughout their whole depth, in
order that they may grow together as quickly
as possible, and without the intervention of
matter. To obtain this very desirable result,
in addition to the means already mentioned,
there are two things to be attended to, the
position of the patient and the application of a
bandage. The position of the patient should
be such as will relax the skin and muscles of
the part wounded, thereby diminishing their
tendency to separate.
A common bandage of a proper width, pass-
ed over the compresses moderately tight, not
only serves to keep them in their place, but
also tends by its pressure, to forward the great
object already mentioned. If, however, the
wound is so extensive and painful that the limb
or body of the patient cannot be raised for the
purpose of applying or removing it, the best
way is to spread the two ends of one or two
strips of linen or leather with sticking plaster,
which may be applied in place of the bandage,
as follows : attach one end of a strip to the
Found skin, at a short distance from the edge
of the compress, over which it is to be drawn
with moderate firmness, and secured in a simi-
lar manner on its opposite side. A second or
third may, if necessary, be added in the same
way.
In all wounds, if violent inflammation come
on, reduce it by bleeding, purging, &.c. but if
there is reason to fear locked-jaw, give wine,
porter, brandy, opium, and a generous diet.
ipS the gentleman's
EXPLANATION OF PLATE I.
A — A view of the handkerchief and stick, as ready
to be applied to the thigh.
B— The same apparatus, when applied.
C — The spot on the thigh where the knot, formed
by the twisting of the handkerchief should press,
the great artery running immediately under it, or
along the inner third of the horizontal diameter of
the thigh .
D D — A wound in the thigh, showing the manner of
bringing its sides together by strips of sticking
plaster.
E— Strips of sticking plaster, crossing the wound at
right angles, and holding its edges in contact.
F— A wound in the ear in which three stitches are
passed by the needle G, the threads being lef
loose until the last stitch is taken
H — A similar wound, showing the stitches when tied
©r knotted .
MEDICAL VADE-MECUM.
169
170 Tin; i.-.'.mu.m il
PUNCTURED WOUNDS
These are caused by sharp pointed instru-
ments, as needles, awls, nails, &x. Having
stopped the bleeding, withdraw any foreign
body, as part of a needle, splinters, bit of glass,
&c. that maybe in it, provided it can be clone
easily ; and if enlarging' the wound a little will
enable you to succeed in this, do so. Though
it is not always necessary to enlarge wounds of
this nature, yet in hot weather, it is a mark ol
precaution, which should never be omitted.
As soon as this is done, pour a little turpentine
into the wound, or touch it with caustic, and
then cover it with a poultice, moistened with
laudanum. This practice may prevent locked-
jaw, which is but too frequent a consequence
of wounds of this description. When matter
forms, cover the part with mild dressings, as a
common sore. Laudanum may be given in
large doses, to relieve pain, and should the in-
flammation be excessive, bleed and purge, in
hot weather, however, bleeding should be em-
ployed in great moderation.
CONTUSED WOUNDS.
Wounds of this nature are caused by round
or blunt bodies, as musket balls, clubs, stones,
&,c. They are in general attended but by little
bleeding ; if, however, there should be any, it
must be stopped. If it arises from n ball which
can be easily found and withdrawn, il i* proper
to do so, as well as any piece of the clothing,
MEDICAL VADE-MECUM. 171
Sic. that may be in it ; or if the ball can be
distinctly felt directly under the skin, make an
incision across it and take it out, but never
•allow of any poking in the wound to search
for such things ; the best extractor of them, as
well as the first and best application in con-
tused wounds, proceed from what they may,
being a soft bread and milk poultice.
Should the inflammation be great, bleed
and purge. Pain may be relieved by lauda-
num, and if the parts assume a dark look,
threatening a mortification, cover them with
a blister.
If the wound is much torn, wash the parts
very nicely with warm water, and then (hav-
ing secured every bleeding vessel) lay them
all down in as natural a position as you can,
drawing their edges gently together, or as
much so as possible, by strips of sticking plas-
ter, or stitches, if necessary. A soft poultice
is to be applied over the whole.
POISONED WOUNDS,
FROM BITES OF MAD DOGS, RATTLE-SNAKES, &C
The instant a person is bitten either by a
mad dog, rattle-snake, or any rabid animal,
or reptile, he should apply a ligature by means
of the stick, above the wound, as tightly as he
can well bear it, and ■without hesitation or de-
lay, cut out the parts bitten, taking along with
them a portion of the surrounding sound flesh,
172 the gentleman's
The wound should then be freely touched
with caustic, or have turpentine poured into
it. Hartshorn's decoction of Spanish flies in
turpentine,* may also be applied to the skin
surrounding the wound. By these means in-
flammation will be excited, and suppuration
follow, which may prevent the usual dreadful
consequences of such accidents. As soon as
the parts are cut out, take off the ligature.
Should the patient be too timid to allow the
use of the knife, burn the wound very freely
with caustic, and place in it a tuft of tow or
cotton, well moistened with Hartshorn's decoc-
tion. The discharge of matter that follows,
should be kept up for some time. The only
reasonable chance of safety, is found in the
above plan, all the vegetable and mineral pro-
ductions that have been hitherto recommend-
ed as internal remedies, being of very doubt-
ful, if of any efficacy.
STINGS OF BEES AND WASPS. BITES
OF MOSCHETTOES, &c.
Nothing relieves the pain arising from the
sting of a hornet, bee, or wasp, so soon as
plunging the part in extremely cold water,
and holding it there for some time. A cold
lead-water poultice is also a very soothing ap-
plication. If a number of these insects have
attacked you at once, and the parts stung arc
* See prescription 1 ;
MEDICAL VADE-MECUM. 173
much swollen, lose some blood, and take a
dose of salts.
Moschetto-bites may be treated in the same
manner, although I have found a solution of
common salt and water, made very strong, the
most speedy and effectual in relieving the pain.
Camphorated spirits, vinegar, Sic. may also be
used for the same purpose.
WOUNDS OF THE EAR, NOSE, &c.
Wash the parts clean, and draw the edges
of the wound together by as many stitches as
are necessary. If the part is even complete-
ly separated, and has been trodden under foot,
by washing it in warm water, and placing it
accurately in its proper place by the same
means, it may still adhere.
WOUNDS OF THE SCALP.
In all wounds of the scalp it is necessary to
shave off the hair. When this is done, wash
the parts well, and draw the edges of the
wound together with sticking plaster. If it
has been violently torn up in several pieces,
wash and lay them all down on the skull again,
drawing their edges as nearly together as pos-
sible by sticking plaster, or if necessary, by
stitches. Cover the whole with a soft com-
press smeared with some simple ointment.
WOUNDS OF THE THROAT.
Seize and tie up every bleeding vessel you
p 2
174 THE gentleman's
can get hold of. If the wind pipe is cut only
partly through, secure it with sticking plaster,
if it is completely divided, bring its edges to-
gether by stitches, taking care to pass the nee-
dle through the loose membrane that covers
the wind pipe, and not through the wind pipe
itself. The head should be bent on the breast,
and secured by bolsters and bandages in that
position, to favour the approximation of the
edges of the wound.
WOUNDS OF THE CHEST.
If it is a simple incised wound, draw the
edges of it together hy sticking plaster, cover
it with a compress of linen, and pass a bandage
round the chest. The patient is to be con-
fined to his bed, kept on a very low diet, and
to be bled and purged, in order to prevent in-
flammation. If the latter comes on, reduce it
by copious and frequent bleedings.
Should it be occasioned by a bullet, extract
it, and any pieces of cloth, &c. that may be
lodged in it, if possible, and cover the wound
with a piece of linen smeared with some sim-
ple ointment, taking care that if is not drawn
into the chest. If a portion of the lung pro-
trudes, return it without any delay, but as
gently as possible.
WOUNDS OF THE BELLY.
Close the wound by strips of sticking plas-
MEDICAL VADE-MECUM. 175
ter, and stitches passed through the skin, ahout
half an inch from its edges, and cover the
whole with a soft compress, secured by a band-
age. Any inflammation that may arise is to be
reduced by bleeding, purging, and a blister
over the whole belly.
Should any part of the bowels come out at
the wound, if clean and uninjured, return it as
quickly as possible ; if covered with dirt, clots
of blood, &.c. wash it carefully in warm water
previous to so doing. If the gut is wounded,
and only cut partly through, draw the two
edges of" it together by a stitch, and return it ;
if completely divided, connect the edges by
four stitches at equal distances, and replace it
in the belly, always leaving the end of the
ligature project from the external wound,
which must be closed by sticking plaster. In
five or six days, if the threads are loose, with-
draw them gently and carefully.
WOUNDS OF JOINTS.
Bring the edges of the wound together by
sticking plaster, without any delay, keep the
part perfectly at rest, bleed, purge, and live
very low, to prevent inflammation. Should it
come on, it must be met at its first approach
by bleeding to as great an extent as the con-
dition of the patient will warrant, and by a
blister covering the whole joint. If a perma-
nent stiffening of the joint seems likely to en-
sue, keep the limb in that position which will
176 THE GENTLEMAN S
prove most useful, that 19, the leg should be
extended, and the arm bent at the elbow.
Wounds of joints are always highly dangerous,
and frequently terminate in death.
WOUNDS OF TENDONS.
Tendons or sinews are frequently wounded
and ruptured. They are to be treated pre-
cisely like any other wound, by keeping their
divided parts together. The tendon which
Connects the great muscle forming the calf of
the leg, with the heel, called the tendon of
Achilles, is frequently cut with the adze, and
ruptured in jumping from heights. This irci-
dent is to be remedied by drawing up the heel,
extending the foot, and placing a splint on the
fore-part of the leg, extending from the knee
to beyond the toes, which being secured in
that position by a bandage, keep the foot in
the position just mentioned. The hollows un-
der the splint must be filled up with tow or
cotton. If the skin falls into the space between
the ends of the tendon, apply a piece of stick-
ing plaster, so as to draw it out of the way. It
takes five or six weeks 10 unite, but no weight
should be laid on the limb for several months.
OF FRACTURES.
The signs by which fractures may be known,
having been already pointed out with sufficient
minuteness, it will be unnecessary to dwell
MEDICAL VADE-MECUM. 1T7
thereon ; it will be well, however, to recollect
this general rule : In cases where, from the ac-
companying circumstances and symptoms, a
strong suspicio?i exists that the hone is frac-
tured, it is proper to act as though it were
positively ascertained to be so.
FRACTURES OF THE BONE OF THE
NOSE.
The bones of the nose from their exposed
situation, are frequently forced in. Any smooth
article that will pass into the nostril should be
immediately introduced with one hand, to raise
the depressed portions to the proper level,
while the other is employed in moulding them
into the required shape. If violent inflamma-
tion follows, bleed, purge, and live on a low
diet.
FRACTURE OF THE LOWER JAW.
This accident is easily discovered by looking
into the mouth, and is to be remedied by keep-
ing the lower jaw firmly pressed against the
upper one, by means of a bandage passed un-
der the chin and over the head. If it is broken
near the angle, or that part nearest the ear,
place a cushion or roll of linen in the hollow
behind it, over which the bandage must pass,
so as to make it push that part of the bone
forward. The parts are to be confined in this
way for twenty days, during which time, all
the nourishment that is taken, should be suck-
178 THE CI.NTJ.KMAis's
ed between the teeth. If in consequence oi
the blow, a tooth is loosened, do not meddle
with it, for if let alone, it will grow fast again.
FRACTURES OF THE COLLAR BONE.
This accident is a very common occurrence,
and is known at once by passing the finger
along it, and by the swelling, &,c. To reduce
it seat the patient in a chair without any shirt,
and place a pretty stout compress of linen,
made in the shape of a wedge, under his arm,
the thick end of which should press against
the arm-pit. His arm, bent to a right angle at
the elbow, is now to be brought down to his
side, and secured in that position by a long
bandage, which passes over the arm of the af-
fected side and round the body. The fore-arm*
is to be supported across the breast by a sling.
It takes from four to rive weeks to re-unite.
FRACTURES OF THE ARM.
Seat the patient on a chair, or the side of a
bed, let one assistant hold the sound arm, while
another grasps the wrist of the broken one
and steadily extends it in an opposite direction,
bending the fore-arm a little, to servo as a le-
ver. You can now place the bones in their
proper situation. Two splints of shingle or
stout paste board, long enough to reach from
• By the fore-aim is meant that part of it which
reaches from the elbow to the wrist. The arm ex-
tends from the shoulder to the elbow.
MEDICAL VADE-MECUM. H9
below the shoulder to near the elbow, must
then be well covered with tow or cotton, and
laid along each side of the arm, and kept in
that position by a bandage. The fore-arm is
to be supported in a sling. Two smaller splints
may for better security be laid between the
first ones, that is one on top, and the other
underneath the arm, to be secured by the
bandage in the same way as the others.
FRACTURES OF THE BONES OF THE
FORE-ARM.
These are to be reduced precisely in the
same way, excepting the mode of keeping the
upper portion of it steady, which is done by
grasping the arm above the elbow. When the
splints and bandage are applied, support it in
a sling.
FRACTURES OF THE WRIST.
This accident is of rare occurrence. When
it does happen the injury is generally so great
as to require amputation. If you think the
hand can be saved, lay it on a splint well cover-
ed with tow ; this extends beyond the fingers ;
place another splint opposite to it, lined with
the same soft material, and secure them by a
bandage. The hand is to be carried in a sling.
The bones of the hand are sometimes broken.
When this is the case, fill the palm with soft
compresses or tow, and th<*n lay a splint on it
180 THE GENTLEMAN S
long enough to extend from the elbow to be-
yond the ends of the fingers, to be secured by
a bandage, as usual.
When a finger is broken, extend the end of
it until it becomes straight, place the fractured
portion in its place, and then apply two small
paste board splints, one below and the other
above, to be secured by a narrow bandage.
The top splint should extend from the end of
the finger over the back of the hand. It may
sometimes be proper to have two additional
splints for the sides of the finger.
FRACTURES OF THE RIBS.
When after a fall or blow, the patient com-
plains of a pricking pain in his side, we may
suspect a rib is broken. It is ascertained by
placing the tips of two or three fingers on the
spot where the pain is, and desiring the patient
to cough, when the grating sensation will
be felt. All that is necessary, is to pass a
broad bandage round the chest, so tight as to
prevent the motion of the ribs in breathing,
and to observe a low diet.
FRACTURES OF THE THIGH.
This bone is frequently broken, and hither-
to has been considered &e most difficult of all
fractures to manage. To the ingenuity, how-
ever, of Dr. Hartshorn, of this city, the world
is iadebted for an apparatus which does away
the greatest impediments that have been found
MEDICAL VABE-MECUJU. 181
to exist in treating it so as to leave a straight
limb, without lameness or deformity - nor is it
the least ox" its merits, that any man of com-
mon sense can apply it nearly as well as a
surgeon.
It consists of two splints made of half or
three quarter inch well seasoned stuff, from
eight to ten inches wide, one of which should
reach from a little above the hip to fifteen or
sixteen inches beyond the foot, while the
other extends the same length from the groin.
The upper end of the inner splint (see Plate IlS
is hollowed out and well padded or stuffed:
Their lower ends are held together by a cross
piece, having two tenons, which enter two
vertical mortices, one in each splint, and secur-
ed there by pins. In the centre of this cross
piece (which should be very solid) is a female
screw. Immediately above the vertical mor-
tices, are two horizontal ones of considerable
length, in which slide the tenons of a second
cross piece, to the upper side of which, is fast-
ened a foot block, shaped like the sole of a
shoe, while in the other is a round hole for
the reception of the head of the male screw,
which passes through the female one just no-
ticed. On the top of this cross piece, to which
the foot block is attached, are two pins, which
fall into grooves at -he head of the screw,
thereby firmly connecting them. The foot
block as before observed, is shaped like the
sole of a shoe. Near the foe, is a slit, through
which passes a strap and buckle. Near the
Q
182 tue gentleman's
heel, are a couple of straps, with two ring*, ai
ranged precisely like those of a skate, of which,
in fact, the whole foot block is an exact re-
semblance. A long male screw, of wood or
other material, completes the apparatus. By
comparing this description with the view of the
machine and its parts, in Plate II, it will be
easily understood.
To apply it, put a slipper on the foot of the
broken limb, and lay the apparatus over the
leg. By turning the screw G the foot block
will be forced up to the foot in the slipper,
which is to be firmly strapped to it, as boys
fasten their skates. By turning the screw
the contrary way, the padded extremity of the
inner splint presses against the groin, and the
foot is gradually drawn down until the broken
limb becomes of its natural length and appear-
ance, when any projection or little inequality
that may remain, can be felt and reduced by a
gentle pressure of the hand.
The great advantages of this apparatus, 1
again repeat, are the ease with which it is ap-
plied, and the certainty with which it act-.
The foot once secured to the block, in a way
that every school-boy understands, nothing
more is required than to turn the screw until
the broken limb is found to be of the same
length as the sound one. It is right to ob-
serve that this should not be effected at once,
it being better to turn the screw a little every-
day, until the limb is sufficiently extended.
As this apparatus may not always be at hand.
MEDICAL VADE-MECUM. 183
it is proper to mention the next best plan of
treating the accident. It is found in the splints
of Desault, improved by Dr. Physic, consisting
of four pieces. The first has a crutch head,
and extends from the arm-pit to six or eight
inches beyond the foot. (See Plate III.) A little
below the crutch, are two holes, and near the
lower end on the inside, is a block, below which
there is also a hole. The second reaches from
the groin, the same length with the first, be-
ing about three inches wide above and two
below. Two pieces of stout paste board, as
many handkerchiefs or bands of muslin, with
some tow, and a few pieces of tape, form the
catalogue of the apparatus.
It is applied as follows. Four or five pieces
of tape are to be laid across the bed, at equal
distances from each other. Over the upper
two, is placed one of the short paste board
splints, well covered with tow. The patient
is now to be carefully and gently placed on his
back, so that his thigh may rest on the splint.
One of the handkerchiefs, or a strong soft band,
is to be passed between the testicle and thigh
of the affected side, and its ends held by an as-
sistant standing near the head of the bed. The
second handkerchief is to be passed round the
ankle, crossed on the instep and tied under the
sole of the foot. By steadily pulling these two
handkerchiefs, the limb is to be extended,
while with the hand, the broken bones are re-
placed in their natural position. The long
splint is now to be placed by the side of the
i 8 4 t n r. r. ext u : man's
paticni, the crutch in the arm-pit, (which u
defended with tow) while the short one is laid
along the inside of the thigh and leg. The
ends of the first handkerchief heing passed
through the upper holes, are to he drawn
tight and secured by a knot, while the ends ol
the second one pass over the block before men-
tioned, to be fastened in like manner, at the
lower one. All that remains is the short paste
board splint, which being well covered with
tow, is to be laid on top of the thigh. The tapes
being tied so as to keep the four splints to-
gether, completes the operation.
Tow is to be every where interposed be-
tween the splints and the limb, and a large
handful of it placed in the groin, to prevent
irritation from the upper or counter extend-
ing band. It is necessary to be careful while
tying the two handkerchiefs, that they are not
relaxed, so that if the operation is properly
performed, the two limbs will be nearly of an
equal length. (See Plate III.)
The superior advantages of Hartshorne's ap-
paratus, over this, as well as all others, must
be evident to every one acquainted with the
difficulty of keeping up that constant extension
which is so absolutely necessary to avoid de-
formity and lameness, and which is so com-
pletely effected by the screw. Next to thai,
however, stands the one just described, which.
can be made by any carpenter in a few minutes,
and which, if carefully applied, will be found
to answer extremely well.
MEDICAL VADE-MEGUM. 185
Fractured thighs and legs generally reunite
in six or eight weeks ; in old men, however,
they require three or four months.*
• In cases of fracture of the thigh or leg, the pa-
tient should always, if possible, be laid on a mattress,
supported by boards instead of the sacking, which,
from its elasticity and the yielding of the cords, is apt
to derange the position qf the limb,
2
18G the gentleman's
EXPLANATION OF PLATE II.
A A A — The inner splint reaching- from the groin
fourteen or fifteen inches below the foot.
B B — The outer splint, that extends from above the
hip the same leng-th.
C— The crutch, padded end of the inner splint in the
groin.
D— The cross piece connecting* the lower ends of
the splints by the tenons E E passing through ver-
tical mortices in both splints, secured by pin F
having a female screw in its centre for the recep-
tion of the male G.
H— The long horizontal mortice, in which slide the
tenons of the second cross piece I, also secured by
pins.
I — The second cross piece, which receives the end
of the foot screw G on one side, and is attached on
the other to the foot block K.
K — The foot block, with the foot fastened to it by
straps.
L— The first cross piece, with its tenons, and the
male screw M M passing through its centre.
N— The groove turned round the head of the screw
for the reception of the pins P.
O — The hole in the side of the second cross piece
for the head of the screw M.
F — The two pins.
Q and V — The foot block with its straps.
R and S— The strap and buckle near the toe.
T T — The two rings, to which are attached the
straps U U, the whole resembling a skate.
.MEDICAL VADE-MECUM.
137
188 the gentleman's
EXPLANATION OF PLATE III.
A A— The long splint, with its crutch end in the aim-
pit.
B — The inner splint, reaching from the groin the
same length as the outer one.
C — The hole at the lower end of the long splint for
securing the second extending handkerchief.
D— The two holes near the upper end of the same,
for securing the first or counter-extending band or
handkerchief.
E— The first band or handkerchief passing between
the testicle and thigh of the affected side, and tied
atD.
F— The second handkerchief that passes over the
block below the foot and fastened at C.
G — One of the short paste board splints, laid on the
top of the thigh, a similar one being underneath it.
H H II — Three tapes securing the whole.
The separate sketch of the long splint A A shows
the mode in which the block B is placed on its inner
side, also its crutch head and holes D and C.
MEDICAL VADE-MLCUM,
189
I
2 »T3
to
>
■s
S
190 she gentleman's
FRACTURES OF THE KNEE-PAN.
This accident is easily ascertained on in-
spection. It may be broken in any direction,
but is most generally so across or transverse-
ly. It is reduced by bringing the fragments
together and keeping them in that position by
a long bandage passed carefully round the leg,
from the ankle to the knee, then pressing the
upper fragment down so as to meet its fellow
(the leg being extended) and placing a thick
compress of linen above it, over which the
bandage is to be continued.
The extended limb is now to be laid on a
broad splint, extending from the buttock to
the heel, thickly covered with tow to fill up
the inequalities of the leg. For additional se-
curity, two strips of muslin may be nailed to the
middle of the splint, and one on each side, and
passed about the joint, the one below, the other
above, so as to form a figure of eight. In twen-
ty or thirty days, the limb should be moved a
little to prevent stiffness.
If the fracture is through its length, bring
the parts together, place a compress on each
side, and keep them together with a bandage,
leaving the limb extended and at rest. Any
inflammation in this, or other fracture, is to be
combated by bleeding, low diet, &c. &c.
FRACTURES OF THE LEG.
From the thinness of the parts covering the
principal bone of the leg, it is easy to ascer-
tain if it is broken obliquely. If, however, the
MEDICAL VAPE-MECUM. 191
fracture be directly across, no displacement
will occur, but the pain, swelling, and the
grating sensation, will sufficiently decide the
nature of the accident.
If the fracture is oblique, let two assistants
extend the limb, while the broken parts are
placed by the hand in their natural position.
Two splints that reach from a little above the
knee to nine or ten inches below the foot,
having near the upper end of each, four holes,
and a vertical mortice near the lower end, in-
to which is fitted a cross piece, are now to be
applied as follows. Lay two pieces of tape,
about a foot long, on each side of the leg, just
below the knee joint, and secure them there by
several turns of a bandage ; pass a silk hand-
kerchief round the ankle, cross it on the in-
step, and tie it under the sole of the foot. The
two splints are now placed one on each side
of the leg, the four ends of the pieces of tape
passed through the four holes and firmly tied,
and the cross piece placed in the mortice. By
tying the ends of the handkerchief to this cross
piece the business is finished.
If the fracture is across, and no displacement
exists, apply two splints of stout paste board,
reaching from the heel to tbe knee, and well
covered with tow, one on each side of the leg,
securing them by a bandage passing round the
limb, and outside the splints.
In cases of oblique fractures of the leg close
to the knee, Hartshorne's apparatus for frac-
tured thighs should be applied, as already di-
rected.
02 the gf.nti.emak"'-;
EXPLANATION OP PLATE IV.
A A— A view of one of the splints.
B— The four holes through which the four pieces of
tape pass.
C— The vertical mortice at the lower end of the
splint.
D— The cross piece that passes through the mortice
connecting the two splints, which are precisely
alike, and to which the handkerchief E is tied.
E E— Shows the manner of passing the handkerchief
round the ankle and over the instep.
F — The bandage that secures the four tapes whose
ends pass through the holes B, and are tied on the
outside of the splint.
MEDICAL VADE-MECUM.
193
ihH THE GENTLEMAN'S
FRACTURES OF THE BONES OF THE
FOOT.
The bone of the heel is sometimes, though
rarely, broken. It is known by a crack at the
moment of the accident, a difficulty in stand-
ing, hy the swelling, and by the grating noi«e
on moving the heel. To reduce it, take a
long bandage, lay the end of it on the top of
the loot, carry it over the toes under the sole,
and then by several turns secure it in that posi-
tion.
The foot being extended as much as possi-
ble, carry the bandage along the back of the
leg above the knee, where it is to be secured
by several turns, and then brought down on
the front of the leg, to which it is secured by
circular turas. In this way the broken pieces
will be kept in contact, and in the course of a
month or six weeks will be united.
Fractures of the foot, toes, &x. are to be
treated like those of the hand and finger!
OF DISLOCATIONS.
The signs by which a dislocation may be
known, have been already mentioned. It is
well to recollect that the sooner the attempt
is made to reduce it, the easier it will be done.
The strength of one roan, properly applied at
the moment of the accident, will often succeed
in restoring the head of a bone to its place,
which iu a few days would have required lb;'
combined efforts of men -
MLDICAL VABp-MEGpi.
several trials with the best apparatus that c;m
be mustered, you find you cannot succeed,
make the patient drink strong hot toddy, of
brandy or other spirits, until he is very drunk.
In this way, owing- to the relaxed state of the
muscles, a very slight force will often be suf-
ficient, where a very great one has been pre-
viously used without effect.
If any objections are made to this proceed-
ing, or if the patient will not consent to it,
having your apparatus (which is presently to
be mentioned) all ready, make him stand up,
and bleed him in that position until he faints ;
the moment this happens, apply your extend-
ing and counter-extending forces. Another
important rule is, to vary the direction of the
extending force. A slight pull in one way,
will often effect what has been in vain attempt-
ed by great force in another.
DISLOCATION OF THE LOWER JAW.
This accident, which is occasioned by blows,
or yawning, is known by an inability to shut
the mouth, and the projection of the chin. To
reduce it, seat the patient in a chair with his
head supported by the breast of an assistant,
who stands behind him. Your thumbs being
covered with leather, are then to be pushed
between the jaws, as far back as possible, while
with the fingers, outside, you grasp the bone,
which is to be pressed downwards,, at the same
time that the chin h raised. If this is properly
196 the gentleman's
done, the bone will be found moving, when
the chin is to be pushed backwards, and the
thumbs slipped between the jaws and the
cheeks. If this is not done, they will be bit-
ten by the sudden snap of the teeth as they
come together. The jaws should be kept
closed by a bandage for a few days, and the
patient live upon soup.
■♦»
DISLOCATION OF THE COLLAR BONE.
This bone is rarely dislocated. Should it
occur, apply the bandages, Sic. directed for a
fracture of the same part.
DISLOCATION OF THE SHOULDER.
Dislocations of the shoulder are the most
common of all accidents of the kind. It is
very easily known by the deformity of the
joint, and the head of the bone being found in
some unnatural position. To reduce it, seat
the patient in a chair, place one hand on the
prominent part of the shoulder blade, just
above the spot where the head of the bone
should be, while with the other you grasp the
arm above the elbow and pull it outwards.
Should this not succeed, lay the patient on
the ground, place your heel in his arm-pit,
and steadily and forcibly extend the arm, by
grasping it at the wrist. The same thing may
be tried in various positions, as placing your-
self on the ground with him, laying him on a
ow bed, while you are standing neat the
foot of it, &c.
MEDICAL VADE-MECUM. 197
If this fails, pass a strong band over the
shoulder, carry it across the breast, give the
ends to assistants, or fasten them to a staple in
the wall ; the middle of a strong band or fold-
ed towel is now to be laid on the arm above
the elbow, and secured there by numerous
turns of a bandage. The two ends of the tow-
el being then given to assistants, or connected
with a pulley, a steady continued and forcible
extension is to be made, while with your hands
you endeavour to push the head of the bone
into its place.
DISLOCATION OF THE ELBOW.
If the patient has fallen on his hands, or holds
his arm bent at the elbow, and every endeavour
to straighten it gives him pain, it is dislocated
backwards. Seat him in a chair, let one per-
son grasp the arm near the shoulder, and an-
other the wrist, and forcibly extend it, while
you interlock the fingers of both hands just
above the elbow, and pull it backwards, re-
membering that under those circumstances,
whatever degree of force is required, should
be applied in this direction. The elbow is some-
times dislocated sideways or laterally. To re-
duce it, make extension by pulling at the wrist,
while some one secures the arm above, then
push the bone into its place, either inwards
or outwards, as may be required. After the
reduction of a dislocated elbow, keep the joint
at perfect rest for five or six days, and thea
r 2
i<38 the gentleman's
move it gently. If inflammation comes on.
bleed freely, purge, &c. &c.
DISLOCATION OF THE WRIST, FIN-
GErvS, &c.
Dislocations of the wrist, lingers and thumb,
are readily perceived on examination ; they
ure all to be reduced by forcibly extending
the lower extremity of the part, and pushing
the bones into their place. If necessary, small
bands may be secured to the fingers by a nar-
row bandage, to facilitate the extension. These
accidents should be attended to without delay,
for if neglected for a little time, they be< oin<
irremediable.
DISLOCATION OF THE THIGH.
Notwithstanding the hip joint is the strong-
est one in the body, it is sometimes dislocu-
ted. As a careful examination of the ji;m,
comparing the length and appearance of the
limb with its fellow, &c. sufficiently mark the
nature of the accident, we will proceed to
state the remedy.
Place the patient on his back, upon a table
covered with a blanket. Two sheets, folded
like cravats, are then to be passed between
the thigh and testicle of each side, (see Plate
V) and their ends (one half of each sheet
passing obliquely over the belly to the oppo-
site shoulder, while the other half passes un-
der the back in the same direction) given to
feveral assistants, or what is much better, tied
MEDICAL VADE-MECBW. 139
very finely to a hook, staple, post, or some im-
moveable body. A large, very strong napkin,
folded as before, like a cravat, is now to be
laid along the top of the thigh, so that its mid-
dle will be just above the knee, where it is
vo be well secured by many turns of a band-
age. The two ends are then to be knotted.
If you have no pullies, a twisted sheet or rope
may be passed through the loop formed by
the napkin. If you can procure the former,
however, cast the loop over the hook of the
lower block, and secure the upper one to the
wall, directly opposite to the hooks or men that
hold the. sheets that pass between the thighs.
A steadily increasing and forcible extension of
the thigh, is then to be made by the men who
are stationed at the pullies or sheet, while you
are turning and twisting the limb to assist in dis-
lodging it from its unnatural situation. By
these means, properly applied, the head of the
bone will frequently slip into its socket with a
load noise.
If, however, you are foiled, change the di-
rection of the extending force, recollecting
always, that it is not by sudden or violent jerks
that any benefit can be attained, but by a stea-
dy increasing and long continued pull. Should
all your efforts prove unavailing (I would not
advise you to lose much time before you resort
to it) make the patient, as before directed, ex-
cessively drunk, and when he cannot stand, ap-
ply the pullies. If this fails, or is objected to,
bleed him till he faints, and then try it again
200 the gentleman's
EXPLANATION OF PLATE V.
A A — The two sheets that are secured to the hooka
B B.
C — The bandage round the leg above the knee that
binds the napkin D.
D — The napkin, with its ends knotted so as to form
a loop, into which is passed the hooks of the pul-
ley E.
E E — The two blocks of the pullies, the upper of
which is fastened to the wall by the hook F, op-
posite hooks B B, while the lower one is connected
with the napkin.
MEDICAL VADE-MECUM.
201
202 THR GENTLEMAirS
DISLOCATION OF THE KNEE-PAN.
When this little bone is dislocated, i< is evi-
dent on the slightest glance. To reduce; it,
lay the patient on his back, straighten the leg,
lift it up to a right angle with his body, and in
that position push the bone back to its place.
The knee should be kept at rest for a lew day?.
DISLOCATION OF THE LEG.
As these accidents cannot happen without:
tearing and lacerating the soft par<s, but little
force is required to place the bones in their
natural situation. If the parts are so much
torn that the bone slips again out of place, ap-
ply Hartshorn's or Desault's apparatus as for
a fractured thigh.
DISLOCATION OF THE FOOT.
The foot is seldom dislocated. Should it
happen, however, let one person secure the
leg, and another draw the foot, while you push
the bone in the contrary way to that in which
it was forced out. The part is then to he
covered with compresses dipped in lend water,
and a splint applied on each side of the leg
1hat reaches below the foot. Accidents of this
nature are always dangerous, all that can be
done to remedy them consists in the speedy re-
duction of the bone, keeping the parts at rest,
and subduing inflammation by bleeding, low
diet, Uc. &c.
MEDICAL VADL-JttXTU. 203
OF COMPOUND ACCIDENTS.
Having spoken of the treatment to be pur-
sued for a bruise, wound, fracture and disloca-
tion, as happening singly, it remains to state
what is to be done when they are united.
We will suppose that a man has been vio-
lently thrown from a carriage. On examina-
tion, a wound is found in his thigh, bleeding pro-
fusely, his ankle is out of joint, with a wound
communicating with its cavity, and the leg
broken.
In the first place stop the bleeding from the
wound in the thigh, reduce the dislocation
next, draw the edges of the wounds together
with sticking plaster, and lastly, apply Harts-
horn's or Desault's apparatus to remedy the
fracture.
If, instead of a wound, fracture and disloca-
tion, there is a concussion or compression of
"the brain, a dislocation and fracture, attend
to the concussion first, the dislocation next,
and the fracture the last.
OF AMPUTATION.
As accidents sometimes happen at sea which
require the immediate amputation of a limb, it
is proper to say a few words on that subject.
To perform the operation, is one thing, to
know when it ought to be performed, is an-
other. Any man of common dexterity and
firmness can cut off a leg, but to decide upon
204 THE GENTLEMAN *S
the necessity of doing bq, requires much judg«
ment, instances having occurred when*, under
the most seemingly desperate circumstance!,
the patient through fear or obstinacy has re-
fused to submit to the knife, and yet after-
wards recovered.
Although in many cases much doubt may
exist in determining whether it is proper to
amputate or not, yet in others, all difficulty
vanishes, as when a ball has carried away an
arm. Suppose for a moment while rolling in
a heavy sea, during a gale, the lashings of a gun
give way, by which a man has his knee, leg or
ankle completely mashed,* or that either of
those parts are crushed by a fall from the top-
gallant yard. The great laceration of blood
vessels, nerves and tendons, the crushing and
splintering of the bones, almost necessarily re-
sulting from such accidents, render immediate
amputation an unavoidable and imperious duty.
If there are none of the regular instruments
on board, you must provide the following,
which are always at hand and which answer
extremely well — being careful to have the
knives as sharp and smooth as possible.
INSTRUMENTS.
The handkerchief and stick, — a carving or
other large knife, with a straight blade, — a pew
knife, — a carpenters tenon or mitre raw, — a slip
of leather or linen, three inches wide and eighteen
• I bave known this very accident to occur only a
few yeafl's ago on board one of our Iiuliamen.
MEDICAL VADE-MECUM. 205.
or twenty long, slit up the middle to the half of its
length, — a dozen or more ligatures, each about a
foot long, made of waxed thread, bobbin, or
fine tzvine, — a hook with a sharp point, — a pair.
of slender pincers, — several narrow strips of
sticking plaster, — dry lint, — a piece of linen,
large enough to cover the end of the stump, spread
with simple ointment or lard, — a bandage three
or four yards long, the width of your hand, —
sponges and warm water.
AMPUTATION OF THE ARM,
OPERATION.
Give the patient sixty drops of laudanum
and seat him on a narrow and firm table or
ehest, of a convenient height, so that some one
can support him, by clasping him round the
body. If the handkerchief and stick have not
been previously applied, place it as high up
on the arm as possible (the stick being very
short) and so that the knot may pass on the
inner third of it. Your instruments having been
placed regularly on a table or waiter, and with-
in reach of your hand, while some one sup-
ports the lower end of the arm, and at the
same time draws down the skin, take the large
knife and make one straight cut all round the
limb, through the skin and fat only, then with
the pen knife separate as much of the skin
from the flesh above the cut, and all round it,
as will form a flap to cover the face of th*
8
2lk> TfTE GENTLEMAN-, s
stump ; when you think there is enough sepa-<
rated, turn it back, where it must he held l>y
an assistant, while with the large knife you
make a second straight incision round the arm
and down to the bone, as close as you can to
the doubled edge of the flap, but taking great
care not to cut it. The bone is now to be
passed through the slit in the piece of linen be*
fore mentioned, and pressed by its ends against
the upper surface of the wound by the person
who holds the flap, while you saw through the
hone as near to it as you can. With the hooks
or pincers, you then seize and tie up every
vessel that bleeds, the largest first, and the
smaller ones next, until they are all secured.
When this is done, relax the stick a little, if
an artery springs, tie it as before. The wound
is now to be gently cleansed with a sponge
and warm water, and the stick to be relaxed.
If it is evident that the arteries are all tied,
bring the flap over the end of the stump, draw
its edges together with strips of sticking plas-
ter, leaving the ligature hanging out at the
angles, lay the piece of linen spread with oint-
ment over the straps, a pledget of lint over
that, and secure the whole by the bandage,
when the patient may be carried to bed, and
the stump laid on a pillow.
The handkerchief and stick are to be left
loosely round the limb,* so that if any bleeding
* This instrument is named because it is presumed
that no Tourniquet can be obtained. Should there b'e
one on board, it is of course to be preferred.
UIxDICiL VADE-MECUM. 207
happens to come on, it maybe tightened in an
instant by the person who watches by the pa-
tient, when the dressings must be taken off, the
flap raised, and the vessel be sought for and
tied up, after which, every tiling is to be placed
as before.
It may be well to observe that in sawing
through the bone, a long and free stroke should
be used, to prevent any hitching, as an addi-
tional security against which, the teeth of the
saw should be well sharpened and set wide.
There is also another circumstance which
it is essential to be aware of; the ends of di-
vided arteries cannot at times be got hold of,
or being diseased their coats give way under
the hook, so that they cannot be drawn out;
sometimes also, they are found ossified or turn-
ed into bone. In all these cases, having armed
a needle with a ligature, pass it through the
flesh round the artery, so that when tied, there
will be a portion of it included in the ligature
along with the artery. The mode ol passing
it will be readily understood by the following
cut, which represents the ligature passed round
the mouth of a vessel that cannot be secured
in the ordinary way. The needle is a curved
one, such as is used by surgeons for this pur-
pose ; a straight one, however, will answer.
When the ligature has been made to encirc e
the artery, cut off the needle and tie it firmly
•in the ordinary way.
2W8 the gentleman's
The bandages, &c. should not be disturbed
for five or six days, if the weather is cool ; if
it is very warm, they may be removed in three.
This is to be done with the greatest care,
soaking them well with warm water until they
are quite soft, and can be taken away without
sticking to the stump. A clean plaster, lint
and bandage are then to be applied as before,
to be removed every two days. At the expi-
ration of fourteen or fifteen days the ligatures
generally come away; and in three or four
weeks, if every thing goes on well, the wound
heals.
AMPUTATION OF THE THIGH.
This is performed in precisely the same
MEDICAL VADE-MECUM. 209'
manner as that of the arm, with one exception,
it being proper to interpose a piece of lint be-
tween the edges of the flap, to prevent them
from uniting until the surface of the stump has
adhered to it.
AMPUTATION OF THE LEG.
As there are two bones in the leg which
have a thin muscle between, it is necessary to
have an additional knife to those already men-
tioned, to divide it. It should have a long nar-
row blade, with a double cutting edge, and a
sharp point ; a carving or case knife may
be ground down to answer the purpose, the
blade being reduced to rather less than half
an inch in width. The linen or leather strip
should also have two slits in it instead of one.
The patient is to be laid on his back, on a ta-
ble covered with blankets or a mattress, with
a sufficient number of assistants to secure him.
The handkerchief and stick being applied on
the upper part of the thigh as in Plate I, let-
ter B, one person holds the knee and another
the foot and leg as steadily as possible, while
with the large knife the operator makes an
oblique incision round the limb, through the
skin, and beginning at five or six inches below
the knee-pan, and carrying it regularly round
in such a manner that the cut will be lower
down on the calf than in front of the leg. As
much of the skin is then to be separated by
§ 2
210 THE GENTLEMAN'S
the pen knife as will cover the stump.* When
this is turned back, a second cut is to be made
all round the limb and down (o the bones, when
ml ' e narrow bladed knife, just mentioned,
thf flesh between them is to he divided. The
middle piece of the leather ^rip is now to be
pulled through between the bones, the whole
b< ing held back by the assistant, who supports
the tlnp while the bones are sawed, which
should be so managed that the smaller one is
completely cut through by the time the other
is only half so. The arteries are then to be
taken up, the flap brought down and secured
by adhesive plasters, &c. as already directed.
AMPUTATION OF THE FORE-ARM.
As the fore-arm has two bones in it, the nar-
row bladed knife, and the strip of linen with
three tails are to be provided. The incision
should be straight round the part, as in the
arm, with this exception, complete it as direct-
ed for the preceding case.
AMPUTATION OF FINGERS AND TOES.
Draw the skin back, and make an incision
round the ringer a little below the joint it is
intended to remove, turn back a little flap to
* The principal part of the flap is to be taken
from the hinder part of the leg-, for the cut being
made as directed, it should require only one inch of
skin to be raised in front, and of course enough must
be takcu behind to meet it.
MEDICAL VADE-MEeVM. 211
rover the stump, then cut down to the joint,
bending it so that you can cut through the
ligaments that connect the two bones, the un-
der one first, then that on the side. The head
of the bone is then to be turned out, while
you cut through the remaining soft parts. If
you see an artery spirt, tie it up, if not, bring
down the flap and secure it by a strip of stick-
ing plaster, and a narrow bandage over the
whole.
REMARKS.
To prevent the troublesome consequences
of secondary bleeding, before the strips of
plaster are applied over the edges of the flap,
give the patient, if he is faint, a little wine
and water, and wait a few minutes to see
whether the increased force it gives to the cir-
culation, will occasion a flow of blood ; if it does,
secure the vessel it comes from. If there
is a considerable flow of blood from the hol-
low of the bone, place a small cedar plug in it.
Should violent spasms of the stump ensue, have
it carefully held by assistants, and give the par
tient large doses of laudanum ; it may, in tact,
be laid down as a general rule, that after every
operation of the kind, laudanum should be
o-iven in greater or less doses, as the patient
Jiay be iu more or less pain.
OF SUSPENDED ANIMATION.
FROM DROWNING.
The common methods of rolling the bod/
212 THE GENTLEMAN b
of a drowned person on a barrel, or holding it
up by tbe heels, &c. are full of danger, and
should never be permitted. If a sjxirk of life
should happen to remain, this violence would
extinguish it forever.* As soon, therefore, as
the body is found, convey it as gently as pos-
sible to the nearest house, strip it of the wet
clothes, dry it well, and place it on a bed be-
tween warm blankets, on the right side, with
the head elevated by pillows. Every part is
now to be well rubbed with flannels dipped in
warm brandy, or spirits of any kind, while ;>
warming pan, hot bricks, or bottles or bladders
filled with warm water, are applied to the
stomach, back, and soles of the feet. During
these operations a certain number of the as-
sistants (no more persons are to be allowed
in the room than are absolutely necessary)
should try to inflate the lungs, by blowing
through the nozzle of a common bellows, or a
pipe of any kind, placed in one nostril, while.
the other with the mouth are kept closed. If
a warm bath can be procured, place the body
in it. Clysters of warm brandy and water,
salt and water, or peppermint water may be
injected.
All these operations, particularly rubbing
the body, and trying to inflate the lungs, should
be continued for six or eight hours, and when
* The seal of the Humane Society beautifully ex-
presses this fact. It represents a little boy blowing
a coal, the motto (if! mistake not) " a spark may re«
main!"
A1EDICAL VADE-MECCM. 213
the patient has come to himself, small quanti-
ties of warm wine, wine-whey, brandy and
water, &c. may be given to him, from time to
time. If, after he has recovered, a stupor or
drowsiness remains (but not before) bleed him
very moderately.
Should the accident occur in winter, and the
body feel cold, as if frozen, previously to ap-
plying warmth, rub it well with snow, ice, or
very cold water. Above all things remember
that perseverance for many hours in the reme-
dies pointed out, may give you the unspeak-
able pleasure of restoring a fellow creature to
life,
FROM COLD.
Take the body into a room, the doors and
windows of which are open, and where there
•is no fire, and rub it with snow,* or cold water.
After awhile, friction with flannels and hot
spirits are to be used, as in the preceding case,
and warmth very gradually applied. The lung?
are to be inflated as directed in cases of drown-
ing, and when the patient is able to swallow,
warm wine, &c. may be given in small quan
tities.
If a limb is frost-bitten, the cold applications
should be continued longer, and warmth be
more gradually applied than when the whole
body is frozen. Care should be taken to handle
* If this can be procured in plenty, the patient,
with the exception of his face, vvhicli should be left
out, may be completely covered with it to the thick*
iiess of two
214 lilt l.KMI.UUA.N -
the parts carefully, so as not to break oil liifr
ear, lip of the nose, &c.
FROM HANGING.
The remedies for this accident are the same
as in drowning, with the addition of taking
away a small quantity of blood, by cupping
glasses, from the neck, or by opening the jugu-
lar vein.
FROM FOUL AIR.
Throw open the doors and windows, or take
the patient into the open air, and seat him, un-
dressed, Avell wrapped in a blanket, in a chair,
leaning a little to the right side, place his feel
or whole body in a bath, and sprinkle his
stomach with cold vinegar or water, and rub
it immediately with flannels dipped in oil.
Clysters of vinegar and water are to be inject-
ed, and when animation returns, continue the
frictions, and give warm mint lea, &.c.
OF SWALLOWING POISONS.
The first thing to be done when a person is
discovered to have swallowed poison is, to un-
certain what it is he has taken, the next, to be
speedy in resorting toils appropriate remedies.
If any one of these cannot be had, try some
Other without loss of time.
ACIDS.
Oil of Vitriol, — Aqiia For Lis, — Spirits of Sec
Salt,— -Oxalic 4cid.
MEDICAL VADE-MECUM. 215
SYMPTOMS.
A burning heat in the mouth, throat and
stomach, — stinking breath, — an inclination to
vomit or vomiting of various matters mixed
with blood, — hiccups, — costiveness or stools
more or less bloody, — pain in the belly, so
great that the weight of a sheet cannot be
borne, — burning thirst, — difficulty of breath-
ing, — suppression of urine, &lc.
REMEDIE3.
Mix an ounce of calcined magnesia with a
pint of water, and give a glassful every two
minutes. If it is not at hand, use flaxseed tea,
rice water, or water alone in large quantities,
until the former can be procured. If it can-
not be obtained, dissolve an ounce of soap in a
pint of water, and take a glassful every two
minutes ; chalk or whiting may also be taken
by the mouth, and clysters of milk be frequent-
ly injected. If the patient will not vomit, put
him in the warm bath, bleed him freely, and
apply leeches and blisters over the parts pain-
ed. If the cramps and convulsions continue,
give him a cup of common tea, with an ounce
of suo-ar, forty drops of Hoffman's anodyne and
fifteen or twenty of laudanum, every quarter of
an hour. No nourishment but sweetened rice
water is to be taken for several days. In these
cases never give tartar emetic, ipecacuanha,
or tickle the throat with a feather, they only
increase the evil.
216 THE GENTLEMAN'S
ALKALIES.
Caustic Pot-ash,— Caustic Soda } —l olai i
kali.
SYMPTOMS.
These substances occasion the same effects
as acids, producing dreadful convulsion-.
REMEDIES.
Take two table spoonsful of vinegar or lime
juice in a glass of water at once, follow it up
by drinking large quantities of sugar and water.
Pursue the same treatment as in poisons from
acids.
MERCURY.
Corrosive Sublimate, — Red Precipitate -Ver-
million.
SYMPTOMS.
Constriction and great pain in the throat,
stomach and bowels, — vomiting of various mat-
ters, mixed with blood, — unquenchable thirst r
—difficulty of urine, — convulsions.
REMEDIES.
Mix the whites of a dozen or fifteen eggs
with two pints of cold water, and give a glass-
ful every two minutes, with as much milk as
can be swallowed, and large doses of ipecacu-
anha. If after the egg mixture is all taken r
the vomitinig does not stop, repeat the dose,
with the addition of more water. Leeches, the
warm bath, blisters, &.c. are to be used to re-
duce the pain and inflammation, as before di-
rected.
MEDICAL VADE-MECUM. 21T
ARSENIC.
SYMPTOMS.
These are the same as produced by the
mercurial poisons.
REMEDIES.
Give large quantities of cold sugar and wa-
ter, until a plentiful vomiting is induced, to as-
sist which, ipecacuanha* may be taken in con-
siderable doses at the same time ;t barley,
rice water, flaxseed tea, milk, &c. should af-
terwards be employed. Oil is never to be
used in this case until the symptoms have consi-
derably abated, or the poison has been ejected.
COPPER.
The symptoms occasioned by swallowing
verdigris, are nearly the same as those of the
mercurial poisons. The great remedy is large
quantities of sweetened water. In addition to
this, use all the means recommended for cor-
rosive sublimate, &c.
ANTIMONY.
Antimonial Wine, — Tartar Emetic,— Butter
of Antimony, #*c.
* To render it more active, ten grains of sulphate
of zinc may be added to it.
' t Equal parts of lime water and sugared water
may also be used
T
218 THE gentleman's
SYMPTOMS.
Excessive vomiting', — pain and cramp in the
stomach, — convulsions, &c.
REMEDIES.
Encourage the vomiting by sugar and water,
and it' after awhile it does not stop, give a
grain of opium in a glass of the sweetened
water, every fifteen minutes. To relieve the
pain, apply leeches to the stomach, throat or
parts affected.
SALTS OF TIN.
Give as much milk as can be got down, and
if it is not at hand, use large quantities of cold
water to induce vomiting. If the symptoms do
not abate, pursue the plan directed for acids.
SALTS OF BISMUTH, GOLD AND ZINC.
Pursue the plan recommended for arsenic.
LUNAR CAUSTIC.
Dissolve two table spoonfuls of common ta-
ble salt, in two pints of water ; a few glasses of
this will induce vomiting. If not relieved,
drink flaxseed tea, apply leeches, &c. as for
acids.
SALT-PETRE.
Pursue the plan recommended for arsenic,
omitting the lime water.
MEDICAL VADE-MECUM. 219
SAL AMMONIAC.
SYMPTOMS.
Vomiting, — pain in the belly, — a stiffness of
the whole body, — convulsions.
REMEDIES.
Introduce your finger or a feather into the
throat to induce vomiting, and give plenty of
sweetened water. To relieve the convulsions
give the tea, laudanum, &x. as for acids, or the
laudanum alone, and to ease the pain in the
belly, apply leeches, &c.
LIVER OF SULPHUR.
SYMPTOMS.
They resemble those caused by salt-petre.
REMEDIES.
Two table spoonfuls of vinegar in a glass of
water, are to be frequently taken until vomit-
ing is brought on, after which, have recourse
to leeches, blisters, &c.
PHOSPHORUS.
The symptoms and remedies are the same
as by poison from acids.
SPANISH FLIES.
SYMPTOMS.
Great pain in the stomach, with obstinate
and painful erections, accompanied by a diffi-
220 the gentleman's
culty, or suppression oi urine, or if any is pass-
ed, it is bloody, — a horror of swallowing liquids,
— frightful convulsions.
REMEDIES.
Make the patient swallow as much sweet
oil ns he can possibly get down. Milk and su-
gar I vtrater are also to be freely used. In
addition to the plan recommended for acids,
>:is of gum arabic, or flaxseed tea, are to
be ejected into the bladder. If no vomiung
is induced, put him in the warm bath, continue
the sweetened water, and rub his thighs and
legs Hrith two ounces of warm oil, in which a
quart ol rr-ounce of camphor has been dis-
solve*'. Eight or ten grains of camphor may
be ;.u\e<l with the yolk of an egg and taken
internally. If there is acute pain in the blad-
der, apply leeches over it.
POWDERED GLASS.
Stuff the patient with thick rice pudding,
bread, potatoes or any other vegetable, then
give him five grains oi tartar emetic to vomit
him, after which, use milk freely, clysters ;ind
fomentations to the belly, with the warm bath ;
leeches, &c. are not to be neglected.
LEAD.
Sugar of Lead, — Extract of Saturn, — White
Lead, — Litharge, — Minium.
MEDICAL VADE-MECUM. 221
SYMPTOMS.
A sweet astringent taste in the mouth,—
constriction of the throat,-pain in the stomach,
bloody vomiting, &c.
REMEDIES.
Dissolve a handful of Epsom or Glauber
salts in a pint of water and give it at once ;
when it has vomited him, use sweetened water.
If the symptoms continue, act as directed for
acids.
OPIUM OR LAUDANUM.
SYMPTOMS.
Stupor,— an insurmountable inclination to
sleep, — delirium, — convulsions, &c.
REMEDIES.
Endeavour to excite vomiting by six grains
of tartar emetic, or four grains of blue, or
thirty of white vitriol. Thrust a feather down
the throat for the same purpose. Never give
vinegar or other acids, until the poison is al-
together or nearly evacuated. After this has
taken place, a wine glassful of lemon juice
and water may be taken every five minutes,
along with a cup of very strong coffee. The
coffee, &c. are to be continued until the drowsi-
ness is gone off, which, if it continues, and re-
sembles that of apoplexy, must be relieved by
bleeding. The patient is to be. forcibly kept
in constant motion.
T 2-
222 the gentleman's
MUSHROOMS.
REMEDIES.
Give the patient immediately three grains
of tartar emetic, twenty-five or thirty of ipe-
cacuanha, and an ounce of salts, dissolved in a
glass of water, one third to be taken every
fifteen minutes until he vomits freely. Then
purge with castor oil. If there is great pain
in the belly, apply leeches, blisters, &c.
■♦■
TOBACCO, HEMLOCK, NIGHT SHADE,
SPURRED RYE, &c.
REMEDIES.
An emetic as directed for opium. If the
poison has been swallowed some time, purge
with castor oil. After vomiting and purging,
if the patient seems drowsy, bleed him, and
give vinegar and water.
POISONOUS FISH.
REMEDIES.
An emetic. If it has been eaten some time,
give castor oil by the mouth and clyster. Af-
ter these have operated, twenty drops of ether
may be taken on a lump of sugar ; vinegar and
water as before mentioned.
■♦»
FOREIGN BODIES IN THE THROAT.
Persons are frequently in danger of suffo-
MEDICAL VADE-MECUM. 223
cation from fish bones, pins, &c. which stick
in the throat. The moment an accident of this
kind occurs, desire the patient to be perfectly
still, open his mouth and look into if. If you
can see the obstruction, endeavour to seize it
with your finger and thumb, or a long slender
pair of pincers. If it cannot be got up, or is
not of a nature to do any injury in the stomach,
push it down with the handle of a spoon or a
flexible round piece of whale-bone, the end
of which is neatly covered with a roll of linen,
or any thing that may be at hand.* If you
can neither get it up nor down, place six
grains of tartar emetic in the patient's mouth.
As it dissolves, it will make him excessively
sick, and in consequence of the relaxation, the
bone, or whatever it may be, will descend into
the stomach or be ejected from the mouth.
If a pin, button, or other metallic or point-
ed body has been swallowed (or pushed into
the stomach) make the patient eat plentifully
of thick rice pudding, and endeavour to pre-
vent him from going to stool for at least twelve
hours.
OF BURNS AND SCALDS.
There are three kinds of remedies employ-
ed in accidents of this nature. Cooling applica-
• The small end of a common riding whip answers
very well.
224 THE gentleman's
tions, such as pounded ice, — snow,— vinegar,
— cold water, — lead-water, &c. Stimulants, a9
warm spirits of turpentine, — brandy, or any
ardent spirits, and carded or raw cotton.
Any one of these articles that happen to be
nearest at hand, may be tried, although the
preference is due to the turpentine or spirits,
which being made as hot as the patient can
bear it, is to be applied to all the burned sur-
face (so as not to touch the adjoining sound
skin) until some common basilicon ointment
can be thinned with spirits of turpentine, to the
consistence of cream, in which state it is to be
spread on a linen rag and laid over the part,
taking care, as before, not to let it touch the
sound skin.
If, however, (the rule is general) this plan
causes great pain and inflammation, it must be
abandoned, and one of the others be resorted
to, as the pounded ice, which can be readily
applied in a bladder. Equal parts of lime wa-
ter and linseed oil well mixed, forms one of
the most soothing of all applications. Should
much fever prevail, it is to be reduced by
bleeding, purging, &c. but if on the contrary,
the system seems to sink, wine, bark, &c. must
be employed.
OF MORTIFICATION.
From what has already been stated it is
evident that in treating wounds, kc. as well as
MEDICAL VADE-MECUM. 226
diseases, one great and important indication is
to repress excessive inflammation, which, if
allowed to proceed to a certain point, some-
times produces mortification or the death of
the parts.
Whenever, therefore, from the viole,: of
the fever, heal, pain, redness and swelling, you
are fearful of its ending in this way, bleed,
purge, &c. to as great an extent as the patient
can bear. If, however, the fever and pain
suddenly cease, if the part which before was
red, swollen and hard, becomes purple and
soft, abandon at once all reducing measures,
lay a blister over the whole of the parts, and
give wine, porter, bark, &c. freely and with-
out delay. If the blisters do not put a stop to
the disease, and the parts become dead and
offensive, cover them with the charcoal or fer-
menting poultice until nature separates the
dead parts from the living, during which pro-
cess, a generous diet, bark, &c. must be al-
lowed.
There is a particular kind of mortification
which comes of itself, or without any apparent
cause. It attacks the small toes of old people,
and commences in a small bluish or black spot,
which spreads to different parts of the foot.
To remedy it, place a blister over the spot,
and give two grains of opium night and morn-
ing, taking care to keep the bowels open by
castor oil, and to diminish the quantity of the
opium if it occasions any unpleasant effects.
22G the gentleman's
In extensive mortifications of the fore-firm,
it is necessary to amputate. This, however,
should never be done, until by the repeated
application of blisters to the sound parts ad-
joining- the mortified ones, they are disposed
to separate, which maybe easily known by in-
spection.
DIRECTIONS FOR BLEEDING.
Tie up the arm, placing the bandage at least
two inches above the projections of the elbow
joint, and then feel for the pulse at the wrist.
If it is stopped, the bandage is too tight, and
must be relaxed. Select the most prominent
vein, and feel with the tip of your finger if an
artery lies near it. If you feel one pulsating
so close to the vein that you are fearful of
wounding it, choose another. Having set your
lancet,* bend the arm to the precise position it
is to be kept in while the blood Hows. The
cutting edge of the lancet is now to be placed
on the vein, while you depress the handle or
frame just as much as you wish the cut to be
deep ; by touching the spring on the side with
your thumb the business is done. To stop the
bleeding, relax the bandage, press the two
edges of the wound together, place a little
compress of linen on it, and bind up the whole
with a bandage passing round the joint in a
figure of eight.
* T allude of course to the spring' lancet, the only
one that can be used with safety. ""
MEDICAL VADE-MECUM. 227
DIRECTIONS FOR PASSING THE CA-
THETER.
Take the penis of the patient near its head
between the finger and thumb of your left
hand (standing beside him) while with your
right you introduce the point of the instrument
into the urinary passage, its convex side to-
wards his knees ; while you push the catheter
down the urethra, endeavour at the same time
to draw up the penis on it. When you first
introduce it, the handle will of course be near
the belly of the patient, and as it descends will
be thrown farther from it, until it enters the
bladder, which will be known by the flow of
the urine. If you cannot succeed while the
patient is on his back, make him stand up, or
place him with his shoulders and back on the
ground, while his thighs and legs are held up
by assistants. If still foiled, place him again
on his back, and when you have got the ca-
theter as far down as it will go, introduce the
forefinger, well oiled, into the fundament, and
endeavour to push its point upwards, while you
still press it forward with the other hand.
Force is never, on any account, to be used.
Vary your position as often as you please, let
the patient try it himself, but always remem-
ber it is by humouring the instrument, and not
by violence, that you can succeed.
DIRECTIONS FOR PASSING BOUGIES.
Take the penis between your finger and
228 MEDICAL VADE-MECUM.
thumb, and pass the point of the instrument
(which should be well oiled) down the urethra
as directed for the catheter ; when it has en-
tered three or four inches, depress the penis a
little, and by humouring the bougie with one
hand, and the penis with the other, endeavour
to pass it as far as may be wished. The patient
himself will frequently succeed, when every
one else fails.
PRESCRIPTIONS,
ABBREVIATIONS AND SIGNS OF QUANTITY.
R. Stands for Recipe or take.
gr. Stands for grains.
dr. Stands for a drachm or three scruples.
oz. Stands for an ounce or eight drachms.
0. Stands for a pint,
gutt. Stands for drops.
ss. Stands for the half of the quantity that precedes it.
1, II, III, IV, Signify the number of grains, drachms, <kc.that
may be placed before them.
No. 5.
R. Chalk Mixture . oz.iv
Tincture of Kino dr. i
Lavender compound dr. i
Laudanum gutt. xxx
A table spoonful every two
or three hours, as may be
required.
No. 6.
R. Cayenne Pepper oz. vi
Common Salt dr. iv
Boiling Water, Boil-
ing Vinegar, each o iss
Let it remain in a close ves-
sel for an hour, then strain
it through a fine linen cloth.
Take a table spoonful eve-
ry hour or two, according to
circumstances.
No. 7.
R. Musk . dr. i
Gum Arab, powdered dr. i
Loaf Sugar . dr. i
Water . . oz. vi
Rub up the musk with the
su^ar, then add the gum
and pour on the water very
gradually ,M as to incorpor-
ate the whole. Take a tabic
spoonful every two hours.
No. 8.
R. Camphor . gr. xxx
Almonds blanched dr. u
Loat Su^ar . dr. is*
Peppermint Water oz. vi
No. 1.
U. Saline Mixture.
Salt of Tartar dr. i
Water . . oz. vii
Ess. of Peppermint, gutt.v
"When the salt is dissolved
add very gradually
Lemon juice . . oz. iss
or till the effervescence
ceases. To be taken every
hour.
No. 2.
R. Sulphate of Quinine gr. xiii
Gum Arab, powdered, dr. i
Loaf Sugar , oz. ss
Water * . oz. vi
Ess. of Peppermint, gutt. v
A table spoonful every hour.
Shaking the bottle well be-
fore it is poured out.
No. 3.
K. Calomel . . gr.vi
Antimonial powders gr. ui
To be taken every three
hours.
No. 4.
R. Effervescing Mixture.
Salt of Tartar gr. xx
Water . • oz. i;
Ess. Peppermint, gutt. n
When the salt is dissolved,
add a table spoonful of le-
mon juice or good vinegar,
and swallow it immediate-
ly.
160
PRESCRIPTIONS.
Moisten the camphor with
a few drops of Spirits of
Wine, and reduce it to pow-
der.'! lie almonds and sugar
having bi:<'n beat to a paste,
add the camphor, and pour
on the water gradually,
robbing- the whole well to-
gether. Take a table spoon-
ful every t» o or three hours.
No. 9.
R. Sugar of Lead
White Vitriol
Laudanum
Rose water
or
Wine of Opium
Water
gr. v
gr. u
dr. ii
oz. vi
oz. ss
Alum . . dr. ss
Kose water . . oz. vi
To bathe the eye frequent-
ly.
No. 10.
R. Barley Water , o ss
Vinegar . . oz. iss
or
Alum . . dr. i
Hice Water . o iss
Honey . . oz. i
or
Vinegar . . oz. ii
Water . . . oi
To gargle the throat.
No. Ii.
R. Barley or Bice Water o ss
Tincture of Myrrh oz. ss
Muriatic Acid dr. ss
or
Sharp Vinegar oz. i
Gargle the throat frequent-
ly-
No. 12.
R. Wine and Vinegar-whey.
Place a saucepan contain-
ing a pint of new milk on
the fire, and while it is boil-
ing add one gill of white
wine or half the quantity of
good vinegar. As soon as
the milk is turned, take it
off, strain the whey through
a cloth and sweeten it to
your taste.
No J 3.
. Paregoric . . oz- as
Sirup of Squills oz. i
Antimonm! Wine dr. ii
Water . oz. vi
Take two tea spoonfuls eve-
ry fifteen minute* until the
cough is relieved.
No. 14.
. The white of one egg.
Castor Oil . oz. ii
Lavender Compound dr. ii
Sugar . . oz. ss
Water . . oz. iv
Incorporate the Oil and the
white of the Egg, by shak-
ing them together in a bot-
tle, then add the water con-
taining the sugar and la-
vender. Htalf oT this quan-
tity may be taken at once,
and the other half in a few
hours, or a table spoonful
every hour until it operates.
No. 15.
i Chalk Mixture oz. iv
Tincture of Kino dr. i
Cinnamon Water oz. u
Laudanum dr. ss
A table spoonful every two
hours, or oftener if neces-
sary.
No. 16.
. Tincture of Catechu oz. ii
Take two tea spoonfuls in *
little port Mine, every hour,
or oftener if required.
No. 17.
Extract of Logwood gr. xx
Cinnamon Water oz. ii
Tincture of Kino dr. i
Sugar . . th-.ii
'1 o be taken at once.
R.
No. 18.
Prepared Chalk
LoaX Sugar
dr. ii
dr. i
PRESCRIPTIONS.
231
Rub them well together and
add gradually of
Mucilage of G.Arabic oz. i
Water • . oz. vi
Lavender Compound dr. ii
Laudanum , gutt. xxx
A table spoonful every hour
or oftener if necessary.
No. 19.
R. Calomel
gr. x
Jalap . .
gr. xii
Opium .
gr. iss
Tartar Emetic
gr. ss
Oii of Aniseed
gutt. 1
Make the whole into a mass
with conserve of roses, and
divide it into tiv-. or six
piils, all of which are to be
taken at once.
No. 20.
H. Socotorine Aloes oz. i
Liquorice . oz. ii
Coriander Seeds oz. ss
Gin or Brandy o. i
Digest the aioes and li-
quorice in the gin for a
week, shaking the bott e
frequent), *nd add to ihe
solution half a pint of a
very strong decoction of the
Carolina pink root. The
dose is two table spoonfuls
every morning, while fast-
ing.
No. 21.
R. Powder ol the root of the
Male Fern dr. i
This is to be taken in mo-
lasses early in the morning,
and for two days in succes-
sion, to be followed with
some very active purgative.
No. 22.
H. Powder of Tin dr. i
Molasses, as much as will
envelop it. Repeat the dose
morning and evening tor
three days, and tlien take
some active purgative,
'""
It. Bark of the fresh root ol
the Pride of China oz. ▼
Water . o. ii
Boil it in a c ; ose vessel to
one pint. .. nej a table
spoonful ev ,- l . o hour*
t. 1 '
Baru
tree i
Water . o. ii
BoH it d
strain it »
wineglass'.' orabo - ii
No.
Mucilage of G. ■. <s
Olive Oil . . ui. ii
Rub them well together
and add
Ether . . dr. i
Laudanum gutt. xs
To be taken at once.
No. 24.
R. Peruvian Bark gr. xx
Uva Ursi . gr. \X
Opium • ;r- ss
Make a powder, to be taken
three times a-day with lime,
water.
No. 25.
R. Comp. Tinct. of Senna oz. i
Comp. Tinct. of Jalap dr. ii
No. 26.
R. Calomel . . gr. \
Jalap . . • gr. xv
Oil of Aniseed gutuii
To betaken in molasses.
No. 27.
R. Comp. Tinct. of Senna oz. i
Wine of Aloes . oz. ii
Simple Sirup . . oz i
Water . • oz. iv
Oil of Mint . gut- u
A table spoonful from i i me
to time, as may be necessary.
No. 28.
Balsam Copaiva oz. ii
Spta. of Turpentine oz. t
Oil of Aniseed gutt. v
Take twenty-flve or thirty
232
PRESCRIPTIONS.
drops, three times a-day on
a lump of sugar R.
No. 29.
R. Sugar of Lead gr.vii
White Vitriol gr. viii
Mucilage of G. Arabic oz.ii
Water . . oz.. v
Laudanum . gun. xx
No. 30.
R. Acetate of Zinc gr. x
Gum Arabic Water oz. vi
R. White Vitriol
Rose Water
Laudanum .
gr.xx
oz. vii
dr. ss
No. 31.
R. Corrosive Sublimate gr. iii
Rose Water oz. viii
No. 32.
R. Blue Vitriol . gr.xii
Water . . oz. vi
No. 33.
R. Balsam Copaiva oz. ii
Lime Water . oz. vi
Gum Arabic Water oz. i
Tinct. of Span, flies gutt. x
No. 34.
R. Corrosive Sublimate gr. xv
Muriate of Ammonia gr. xv
Water . . dr. iss
Dissolve and add as much
dry crumb of bread as will
make a mass, which is to be
divided into 120 pills.
No. 35.
R. Muriate of Ammonia oz. ss
Vinegar . . oz. ii
Proof Spirits . . oz. iii
Water . . oz. iii
Mix them for a wash.
No. 36.
Scudamore'i lotion for Gout.
.Ft. Alcohol . . oz. iii
Camphor Mixture oz. ix
Reader the whole milk
■warm, by a sufficient quan-
tity of boiling water.
No. 37.
Water of \mmonia dr. ii
Olive Oil . . oz. iss
Laudanum . ox, ■■
To be well shaken.
No. 38.
Burnt Sponge dr. vi
Powder of G. Arabic dr. i
Powder of Ginger dr. s<
Simple Sirup, as much a*
will lorin a mass, which di-
vide into twelve equal parti,
which are to be dried before
the lire, and kept in some
close vessel. One part every
morning, left in the mouth
till it dissolves, is a dose.
No. 39.
Opium in fine powd. dr. iiss
Soap Liniment oz. ii
Spirits of Camphor oz.ii
Pour the Liniment gradu-
all) on the Opium, and rub
them well together, then
add the Spirits ot Camphor.
No. 40.
Siilph. of Quinine gr. viii
Sirup of Rhubarb oz.iiss
Orange flower Wat. oz. iiss
Sulphuric Ether gutt. x
No. 41.
Muriat. Tine, of Iron oz. ii
Take twenty drops three
times a-day, in a wine glass
of the cold infusion of bark,
or
Extract of Bark dr. i
Extract of Gentian dr. i
Green Vitriol dr. ss
Myrrh . . dr. i
Oil of Aniseed gutt. x
Simple Sirup sufficient to
make the whole into uiuiiss,
to be divided into MXly pills,
of which, take three twice
a-day,
or
Rust of Iron . dr. i
Conserve of Roses, as much
as will make a mass, to be
PRESCRIPTIONS.
235
divided into sixty pills, of
wh ich take two, three times
a-day.
Vo. -12.
R. Calomel . . dr. ss
Tartar Emetic gr. xv
Opium . dr. ss
Add of Sirup as much as
Will form a smooth mass,
and divide it into sixty pills.
OF POULTICES.
Test Poultice.
R. Into an infusion of malt or
beet stir as much oatmeal as
will make it of a proper
thickness, and then add a
few spoonfuls of yest.
Charcoal Poultice.
R. To ha'fa pound ot common
rye mush, add two table
spoonfuls of finely powder-
ed f'rtsh made charcoal, and
stir them well together.
Rye Meal Poultice.
R. This is made precisely like
rye mush, care being taken
to have it very smooth.
OF CLYSTERS.
Emollient Clyster.
R. Thin Starch, one pint. Mo-
lasses, a w ine glassful,
or
Molasses, a wine glassful,
SweelOil,thesame quanti-
ty. Warm Barley Water,
one pint,
or
Flaxseed Tea, one pint f
Milk, half a pint.
Anothjne Clyster.
This is formed by add-
ing forty, fifty, sixty, or
more drops of Laudanum
(as occasion may require) to
the Emollient Clyster.
Purgative Clyster.
Take of Table S:,lt and
Brown Sugar a tab;e spoon-
ful, add to them half a sill
of Molasses, and rub them
well together. Whih vnu
are stirring them, gradual-
ly pour in two oujv.i 9 of
Castor Oil, and a pint of
warm Water.
Tobacco Clyster.
Infuse one drachm of To-
bacco in a pint of boiling
Water for ten mil utes.
The one half is to be in-
jected first, and if this will
not produce the wished- for
effect in halfan hour, throw
up the remainder.
Hartsliurne's decoction of
Spaniili fiies t in Spirits of
Turpentine,
Spanish Flies bruised, 02.
Spirits of Turpentine, o. ss
Boil for three hours and
strain.
U 2
INDEX.
Page.
Abscess, common - lsi
psoas - - 152
Air, night, injurious effects
of
Acidities in the stomach 59
Acute, rheumatism - 102
Affection, painful, nerves
of the face - - 117
Ap;nes, • . 25
Ague cake, 6fi
Apoplexy, - . Ho
Asthma, - - 51
Accidents, rules in case of 159
— compound 213
Aneurism, ... 145
Amputation, when necessa-
ry - - - 204
~~ ~~ ~ ■ instruments for 204
— — — of the arm 205
of the fore-arm 210
of the thigh 208
of the leg 209
"~~— — — of fingers and
toes - . 210
Arteries, how to distinguish
from veins - 21
bleeding from, how
to stop - . 163
Angina pectoris - 118
Animation, suspended - 211
~— from drowning 212
-from cold 21~
from foul air 214
"— *■ from hanging 214
B,
Bilious fever, - 28
Biles, - - - 148
Bile, obstruction of 64
vomiting of • 68
Bites of mad dogs . 171
rattlesnakes, &c. 171
moscbettoes, 172
Burns and scalds, - - 22.'
Bubo, venereal - eg
sympathetic - 91
Page.
Blotches, venereal, on the
skin - - 95
' - on the face, 117
Brain, inflammation of 87
coiicnssion of 1«2
compression of 16'!
Blood, vomiting of 62
spitting of - 52
letting of - 11,22ft
Bleeding from the nose, 42
from the lungs 52
from the stomach 0^
from the funda-
ment, - 69—141
from wounds, how
to stop 163, 169, 207
Blindness, night - 41
Bladder, inflammation of 80
how to puncture 84
stone in - RS
Bpagie, introduction of 227
Bismuth, poison from - 218
Belly-ach, dry - 75
C.
Coffee in travelling - 10
Cold, how to avoid danger
from - 12
apparent (Uath from 213
Cramp, different kinds of 114
in the stomach, 58
Cow-pox, - . 128
Catarrh, - - - 50
Costiveuess, how to over-
come - 29,74, 76
Convulsions, 76,112,^20,119
Consumption,
Concretions, gouty
Colic, bilious
painter's
Clap, simple
virulent
Chordee, - .
Cli ancies,
Cholera morbus,
Chicken-pi ,.
53
100
73
75
89
90
91
93
68
1'T
Carbuncle,
Cancer, • •
of the lip, -
of the tongue,
of the yard,
— — of the testicle,
Cartilage, pieces of, in the
joints - -
Charcoal, poultice of
Collar bone, fractureof
96
oo
ior.
833
178
• dislocation of 1 Q 6
INDEX.
Page, i
- 148 Dyspepsia,
108 Dislocation, signs of
43 '
44
bone,
235
Page.
60
160
of the jaw, 195
of the collar
196
of the shoulder 196
of the elbow, 197
of the wrist
and fingers, - 198
of the thisrh,
198—201
— — — of the knee-
pan, - - 202
of the leg, 202
of the foot, 202
40
Compression of the brain, 162
Contraction of the throat, 49
Concussion of the brain, 162
Contusion or bruises, t*l
Contused wounds. - 170 j Dimness of sight,
Catheter, introduction of 227 Drowning, recovery from 212
Corrosive sublimate, value of 94 E.
poison Eyes, inflammation of
from - - 21fi Erysipelas,
Compound accidents, 203 — ■ mercurial
Cellular membrane, what it Epilepsy,
i s - . . 19 Emissions, seminal
Chronic rheumatism, 103 Ear, psin in
D. I insects in
Diseases, how to be divided 18 Encysted tumours
Dropsy of the chest
> of the belly,
, of the h.i?,
of the knee joint
Diseases of the head,
of the throat,
of the chest.
of the stomach,
of the liver,
of the intestines,
. of the kidneys,
of the bladder,
_ of the genital «r
gans
of the joints,
of the nerves,
of the glands,
of the skin,
Diabetes,
Deafness,
Dance of St. Vitus
Dianho-a or lax, - "■
Difficulty of breath-
ing, 51,53,118
.-of urine, • °i
Dry belly-aeb,
Dysentery,
30
121
123
112
92
41
42
147
55 Enlargement of the sper-
87 matic veins, - 98
97 — — of the uvula, 45
104 of the tonsils, 46
37 of the glands, 107
46 External piles, - - 150
50 Effervescent draught, 229
56 _____ poultice, 233
62 F.
66 Flannel, use of, next the skin 9
78 Fog, travelling in - 1"
80 I Face, blotches on 1S7
Fever in general - 23
89 I simple inflammatory 23
100 intermittent or ague 25
HO bilious remittent 28
107 .— typhus - 31
120 putrid - - 33
86 hectic - 36
43 scarlet - - 120
119 Fish, poisonous - 222
Fistula in alio, - - 153
in perinco - 154
Flux, bloody 69
Frost-bitten, - 213
Fore-arm, fracture of - 179
— amputation of 210
69
236
INDEX.
Page.
Fractures, signs of - 160
— — — — — of the bones of
the nose, - - 177
of the lower jaw, 177
of thv collar-bone 178
of the ribs, 180
————— of the arm, 178
of the fore-arm, 179
of the wrist, 179
of the fingers, 180
ofthe thigh, 180—187
of the leg, 190—193
of the foot, 194
19.1
no
149
I.
Page*
of the toes,
Fainting,
Felon,
G.
Gleet, ... 91
Gravel, - - - 79
Gout, - 100
Gonorrhoea, - - 89
Goitre, - - - 109
Glands, inflamed - - 107
sehirrus - 108
cancerous - - 108
Gall stones, 65
Ganglion, - - - 147
Genital organs, diseases of 89
Gun-shot wounds, - 171
H.
Head, diseases of » 37
ach, - - 38
■ ■ — ■ giddiness in 38, 112
scald - • 135
Heart burn, - 59
palpitations of 55
Hydrothorax, - 55
Hip-joint disease, - 104
Hernia or ruptures, - 140
reducible f 340
irreducible - 142
■strangulated 142
Incised wounds,
nee of urine,
i i raj .i in ofthe brain,
of the eyes,
ofthe ear,
of the throat,
ofthe lungs,
134
1M
Hiccups,
Herpes, -
Handkerchief and stick,
how to apply -
Hand-barrow , how to make
quickly - - 159
Hints to travellers, • 9
Hecnc fever, - 36
Hartshoi ne's apparatus for
fractured thighs, view
of • - 187
84
•7
39
41
4ft
52
— ofthe stomach, 5ft
'■ of the intes-
tines, - 66
— — ■— — — ofthe liver, 62
— ofthe kidneys, 78
Of the bladder, 80
of the spleen, 66
of the testicle, 91
— — — of theglands, 107
Injections, danger of strong 91
Impotency, - 99
(pdigestion, - - 60
inflammatory fever. 23
— sore throat, 4$
' ■■ rheumatism, 102
Itch, - - 133
Influenza, 50
Inoculation, cow-pox 125
■ remarks on 131
Intermittent fevers, - 25
Intestines, diseases of 66
inflammation of 66
wounds of 175
— descent of 149
Insects, bites of • 172
Introduction of the cathetcr,227
of bougies, 827
Joints, diseases of • 100
dislocations of I''4
wounds of - 17.»
piecesof cartilngein 106
white swelling of 105
Jaundice,
Jaw, locked •
dislocated
fractured • .
Julaps, mint -
K.
Kidney, inflammation of
King's evil,
Knee-pan, fracture of
dislocation of
I..
Leg, amputation of -
64
115
195
177
11
78
106
190
202
INDEX.
237
Page.
- 203
190—193
232
Leg-, dislocation of
■*■*-; fracture of
Liniment, volatile
— of opium, &c. 232
Lip, cancer of 43
— — wounds of 173
Lower jaw, fracture of 177
dislocation of 195
Liver, acute inflammation of 62
— — chronic - 63
— — — suppuration of
Locked jaw,
Lungs, inflammation of
— ■ — bleeding from
— —- — ulceration of -
Ligatures, how to make
Lancet. spring-
Lax, state of the bowels
Laudanum, poison from
M.
Measles, •
Mercurial disease,
— erysipelas, -
ulcers of the
mouth,
Moschettoes, bites of
Mortification
Mercury, poison from
Mushrooms, poison from
Mixture, saline
■ quinine
— f effervescing -
— — chalk
Cayenne pepper
musk
— — camphor
N.
Nervous fever,
Nerves, diseases of
Nettle rash,
Night blindness
Nocturnal emissions
Nodes, venereal
Nose, polypus of -
fracture of -
— — wounds of -
— — bleeding from
O.
Obstructions in the throat
. in the jowels,
in the urinary
canal,
Opthalinia
172
224
216
222
229
229
229
229
225
229
229
31
110
156
41
92
94
43
177
173
42
49 I
30
92 !
39
Page.
Operation for tapping the
bladder - - 84
P.
Pulse, of the
Patella, dislocation of
fractures of
Phyruosis,
Para-phymosis,
Piles,
Poison, mineral
■ vegetable
■ from aqua fortis,
— — oil of vitriol, 215
^— — — muriatic acid, 215
oxalic acid, 215
— corrosive sub-
216
21
202
190
SO
90
150
214
221
215
216
216
limate,
- red precipi-
tate,
- vermilion,
— causti .: ' ot
ash, - - - 216
— caustic soda, 216
volatile alkali,216
— — — — verdigris 217
-— — — arsenic, 217
- antimonial
wine, 218
- M -, - tartaremetie, 218
- ' - butter of anti-
mony, - - 218
salts of tin, 218
-———saits of bis-
muth, - - - 218
salts of gold, 218
—— — salts of zinc, 218
—— lunar caustic, 218
salt-petre, 218
- sal ammoniac,219
— liver of sul-
phur, - - 219
phosphorus, 219
Spanish Hies, 219
- powdered
glass, - - 220
— sugar of lead, 220
white lead, 220
litharge, 220
minium, 220
laudanum, 221
mushrooms, 222
tobacco,
hemiock, 222
night shade, 222
238 ini
Pn R . .
Poison from spurred rye, 223
Bib, "- 222
wounds, 371
Polypus of the nose, - 43
Psoas abscess. - 1*2
Punctured wounds, - 170
Palpitations of the heart, 55
Palsy, - 113
Passion, iliac
Penis, cancer of - 96
Perineum fistula in 154
Painter's colic, 7*
Pleurisy, 52
Po\, venereal 93
— — - chicken - 126
— — cow - - - 126
small - 131
Pal , •ailing' of the - 45
ry consumption, S3
P . - - 71
f and vomiting* 68
Pi c aracter of • 54
Putr.>i »er, - - 33
— — sore throat, - 47
Quartan ague, - - 25
Qi-oiidianague, - 25
R.
Rules, general - - 159
R; so, nettle - - 136
Ra.c e snake, bite of - 171
R-^uUr gout, - - 101
Remittent fever, - 28
Reanimatioc, means for 211
Rheumatism, inflammatory 102
1 chronic - 103
Round worm, - 77
Ring worm, - - 136
Retention of urine, - 82
Ribs, fractures of - 180
Ruptures, reducible - 140
■ ■ irreducible - 142
strangulated 142
S.
Sick rooms to be well ven-
tilated, - - 17
Scft'ds ind burns - 223
Scirrhus, - - 108
Scurvy, - . 138
Scrofula, - - - 106
Serpents, bites of - 171
Stone .n the biadder, - 85
in the kidney 79
strangulated rupture, 149
P-igp.
1
49
211
03
121
135
120
119
74 i Sanguineous apoplexy, - 110
Stricture in the umbra,
in the throat.
Suspended ani
Syphilis or pox,
St. Anthony's fire, -
Scald bead,
: Scarlet fever,
St. Vitus' dance, -
111
Serous apoplexy,
Semen, involuntary emis-
sions of ...
Sight, dimness of
Small pox ...
Snakes, bites of •
Spine, injuries of - 114—161
Suppression of urine •
Sore throat, inflammatory
putrid
venereal
9*
40
131
171
46
Stomach, inflammation of
1 cramp in
■- gout in
rheumatism in
Stroke of the sun, - 112
Sprains, - • 161
Spleen, enlarged 68
Spitting of blood, - 52
Spasm. - 76,112,220,119
Stitches, how to take - 166
Splints for a fractured arm, 178
— — — for a fractured fore-
arm. .... 179
lor a fractured wrist, 179
— — — Hartshorne's, for a
fractured thigh, 180— 1ST
— — Desault's, for the
same, - - 180—189
for a fractured
leg, - - 190—193
T.
Testicle, swelled - - 91
— ■ cancer of - 99
Tetanus, or locked jaw, 115
Tetters, - - - 134
Typhus fever, - - - 31
Tympany, gg
Tongue, cancer of 44
wounds of - 165
ulcers on - - 44
Throat, inflammatory sots 46
pins, needles, &.c.
222
49
INDEX.
__. , _ Page.
Thigh, fractures of - 180
dislocations of - 198
amputation of - 208
Tonsils, enlargement of 46
Tourniquet, field, to ap-
ply 168—169
Truss, application of
Tape worm, ...
Thread worm,
Tumours, what are meant
by --- -
from ruptures,
' ' ,- aneurismal -
steatomatous
• encysted
ganglions, called 147
Tic doloureax,
117
V.
Ulcers, meaning of - 154
— — — inflamed - - 155
■ - fungous - - I s *
sloughing - - 156
indolent - - 156
carious - I* 7
venereal . - 45
scorbutic - - 135
— scrofulous - - 107
— — - mercurial . - 43
Uvula, enlargement of 45
amputation of - 45
Urinary organs, diseases of 80
Urine, immoderate flow of 81
difficulty of - 81
■ ■ — suppression of - 82
— — incontinence of 84
bloody - - ?9
scalding - - 89
V.
Vein, enlarged spermatic 98
Vegetable poisons
Venereal disease,
Vaecin tion,
Vitus, St. dance of
Vomiting of blood, -
and purging
W.
W arts, venereal
Wasps, stings of •
Water, change of
in the chest
— — in the belly,
in the hag,
Worms, white thread
long round
tape
White swelling, -
Whitlow,
Wax, hard, in the ear,
Wounds,
— incised
— — contused -
— — gun-shot
punctured
— — poisoned
of the scalp,
of the ears, -
of the nose,
of the throat,
of the chest, -
of the belly,
of the intestines,
of joints, t
of tendons,
Wrist, dislocation of
Y.
Yellow fever,
Yest, poultice of - •
Yard, cancer of
239
Page.
•221
- 93
- 127
119
- 62
63
. 96
17%
. 11
55
77
77
77
105
149
41
163
165
179
171
170
171
173
173
173
173
174
174
174
17*
176
198
■ 28
233
»6
FINIS.
ERRORS.
Page 3, line 9, for be carefully, read are carefully,
- 13, — — 3, for remember never to go to, read
beware of going to.
■ " 27, 1, for three or four times a-day, read
every hour or two.
31, 2, for No. 29, read No. 4.
50, 24, for a tea spoonful, read two tea
spoonfuls.
78, 6, after Madam Nouffler, for No. 26,
read the basis of which is No. 21.
83, 14, for No. 30, read No. 23.
84, 10, for finger the, read finger for the.
In addition to the above (owing to causes it is use-
less to state) a few trifling errors have crept in. As
the) do not affect the meaning, they have not been
particularized.
• * ARMY * *
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